Fairview Zoom Fit Waiver
Please complete this form for participation in Fairview's zoom offered fitness classes. During virtual fitness classes where we cannot assist you in person, please listen to your body and use your discretion to choose which exercises you do and how intensely you participate. Safety is our utmost priority. Participating in these exercise activities is done entirely at your own risk. You should receive clearance from your physician before starting any new fitness program.
Name *
Phone Number *
Email Address *
Fairview Membership Key Tag Number:
I am aware the information in this document will be handled with confidentiality and the Fairview Mennonite Home (Seniors Community) will collect, use and disclose my personal information as required and permitted by law *
I hereby acknowledge and agree participation in virtual Group Fitness with Fairview Mennonite Home (Seniors Community) involves risk of injury and that as a condition to participation in virtual fitness programs, I assume full responsibility of such risks. It is my responsibility to ensure I am physically able to participate. I further acknowledge it is my responsibility to abide by any instructions and restrictions imposed by Fairview in respect to my participation. I confirm it is not the responsibility of Fairview Mennonite Home (Seniors Community) to review nor obtain the consent of any physician for my participation. I hereby release the Fairview Mennonite Home (Seniors Community) and its officers, directors and employees from any duty to conduct a physical examination before I participate in virtual classes. For myself and my heirs, hereby fully and forever release the Fairview Mennonite Home (Seniors Community) and its officers, directors, and employees from any and all actions, damages, and demands of whatsoever kind or nature at law or in equity which I may have against the Fairview Mennonite Home (Seniors Community) from my participation in virtual fitness classes.
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