PA Heat Open Gym Release Form
Please fill in the required information below. This information is being collected in compliance with Public Health Department guidelines.
Athletes Name *
Parent / Guardian Name *
Parent Phone Number *
Date of Open Gym *
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By the option below I agree to follow all guidelines set forth by PA Heat All Stars and the CDC and understand that refusal to wear a mask or adhere to social distancing will result in me and or my child being refused entry into the open gym. *
Because physical exercise can be strenuous and subject to risk of serious injury, we urge you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity. You agree that by participating in physical exercise or training activities, you do so entirely at your own risk. Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you understand the risks of remote virtual classes and or individual training sessions and you are solely responsible to only participate in activities and attempt movements that you can do safely. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death. We are also not responsible for any loss of your personal property. You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge the trainer or instructor from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the trainer or instructor for personal injury or property damage. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence. If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from. By signing this release, I acknowledge that I understand and agree to its content and that this release cannot be modified orally. *
By Virtually Signing below I agree to all terms and conditions set forth in this form. *
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