Mike Wong Fitness - Personal Injury Waiver

Personal Injury Waiver and Photography/Media Consent

I understand that my participation in exercise programs, classes or events and any related activity conducted by MIKE WONG/MIKE WONG FITNESS LIMITED is voluntary and at my own risk.

I am aware that exercise can be physically stressful and, in certain instances, even result in injury or cause of death. The levels of exercise that I will perform will be at my own pace, based upon my cardiorespiratory fitness, muscular strength, movement capabilities and endurance levels.

I hear by state that I will inform MIKE WONG/MIKE WONG FITNESS LIMITED of any symptoms (E.G. fatigue, shortness of breath, chest discomfort, any pain/discomfort/concern for my safety) during my participation in exercise. If I have high blood pressure, diabetes, a heart condition, any existing injury, recent surgery or if I am taking any prescribed medications that could affect my performance, I will inform MIKE WONG/MIKE WONG FITNESS LIMITED prior to participating in any exercise.

Please confirm below

I understand that I will be given instructions on how to perform an exercise and use equipment and I will ask the trainer if there is anything I do not understand before starting to exercise.

MIKE WONG/MIKE WONG FITNESS LIMITED, will not be liable for any injuries or damage arising from participation in training to the undersigned.

By taking part in training with MIKE WONG/MIKE WONG FITNESS LIMITED I agree that full rights to the use of images resulting from photography/video filming during my training, and any reproductions or adaptations of the images can be used for fundraising, publicity or other purposes to help achieve the aims and objectives of MIKE WONG/MIKE WONG FITNESS LIMITED.
This might include (but is not limited to), the right to use them in printed and online publicity, social media, press releases and funding applications.

Please confirm one of the following

I consent to MIKE WONG/MIKE WONG FITNESS LIMITED photographing and/or filming me and for these images or videos to be used for marketing and other promotional uses, including (but not limited to) it’s use on www.mikewongfitness.com and its associated social media sites.

I do not consent to MIKE WONG/MIKE WONG FITNESS LIMITED photographing and/or filming me and/or that where I am included in photographs/videos containing other people, these photos will not be used for the purposes aforementioned

I acknowledge that I have read this document in its entirety and understand the above. I have had the opportunity to ask questions and receive answers.

Signed

Date:

Print name: