Waiver and Release of Liability
www.crossfitsfs.com | CrossFit SFS
43 Sheppard, HUME, ACT, 2620
In consideration of CFSFS allowing me to participate, I acknowledge, understand and am aware that:
I have voluntarily chosen to participate in training activities provided by coaches, trainers and staff of CrossFit SFS. I understand there are inherent risks in all aspects of physical training and I acknowledge that I have been informed of the possible strenuous nature of the training and the potential for undesirable physiological results including, but not limited to, abnormal blood pressure, muscle soreness, fainting, heart attack and/or death. I also acknowledge that I have been specifically warned about the medical condition “Rhabdomyolysis” and accordingly I have been advised to limit my effort in order to minimise the risks associated with this condition. Initials: __________
I understand that the training may involve weightlifting, gymnastics movements, strenuous bodyweight exercises and other high exertion activities, and that I am not obligated to perform nor participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during my training sessions. I understand that should I feel lightheaded, faint, dizzy, nauseated, or experience pain or discomfort, I am to stop the activity and inform my trainer. I give CrossFit SFS and the staff of the facilities I train permission to seek emergency medical services for me should I become injured or ill with the understanding that I am responsible for any expenses incurred. Initials: __________
I agree to WAIVE ANY AND ALL CLAIMS that I have or may have in the future against CrossFit SFS, and its directors, officers, employees, agents, volunteers and independent contractors (all of whom are hereinafter collectively referred to as “the
Releasees”). I agree to RELEASE THE RELEASEES from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer as a result of my participation in the programs, activities and services provided by CrossFit SFS, due to any cause whatsoever including negligence, breach of contract, or breach of any statutory or other duty of care. I agree to HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damage to the property of, or personal injury to, any third party, resulting from my participation in any program, activity or service provided by the
releases. Initials: __________
This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with CrossFit SFS to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child. Initial: __________
Use of picture(s)/film/likeness: I agree to allow CrossFit SFS to use picture(s), film and/or likeness of me for advertising purposes. In the event I choose not to allow the use of the same said purpose, I agree that I must inform CFSFS of this in
writing. Initial: __________
COVID Policy
I acknowledge the contagious nature of Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing and wearing face coverings.
I further acknowledge and agree that CrossFit SFS has put in place reasonable preventative measures to reduce the spread of Coronavirus/COVID-19 and other viruses and illnesses.
I further acknowledge and agree that CrossFit SFS cannot guarantee that I will not become exposed to or infected with Coronavirus/Covid-19 or any other virus or illness while using CrossFit SFS facilities or equipment. I understand and agree that the risk of exposure to Coronavirus/COVID-19 and other viruses and illnesses is inherent and unavoidable with regard to the activity of visiting and working out in a gym or similar facility.
I understand and agree that this risk may result from the actions, omissions, or negligence of myself and/or others, including, but not limited to, CrossFit SFS Gym staff, members, clients, guests, and others using or visiting CrossFit SFS Gym facilities.
I voluntarily seek services provided by CrossFit SFS Gym and acknowledge that by doing so I am increasing my risk of exposure to Coronavirus/COVID-19 and other viruses and illnesses. I acknowledge that I must comply with procedures to reduce the spread or Coronavirus/COVID-19 and other viruses and illnesses at any CrossFit SFS Gym facility.
• For my protection and the protection of others , in consideration of being granted access to CrossFit SFS facilities and equipment, and knowing that CrossFit SFS and its staff, members, clients, guests, and others will act in
reasonable reliance on the truth of my statements herein, I represent, warrant, and attest that:
• I am not experiencing any symptom of illness, including but to limited to cough, shortness of breath or difficulty breathing, fever, chills, shaking, muscle pain, headache, sore throat, or loss of taste or smell.
• I have not travelled internationally within the last 14 days.
• I have not travelled to a highly impacted area within the United States of America in the last 14 days.
• I have not been exposed to anyone with a suspected and/or confirmed case of Coronavirus/COVID-19 or any other contagious disease or illness in the last 14 days.
• I have not been diagnosed with Coronavirus/Covid-19 or any other contagious disease or illness (unless I have also been cleared as non-contagious by public health authorities after being so diagnosed).
• I have been following and will continue to follow all applicable guidelines relating to the prevention of disease and prevention of the spread of disease issued by the CDC and by the public health departments/officers of the cities, counties and states in which I work, live, and visited within the past 14 days, and in which the CrossFit SFS facilities which I use are located.
• On behalf of myself, my family members, my heirs, representatives, and successors, I hereby willfully and voluntarily acknowledge and accept the risks of being present at and using CrossFit SFS facilities and equipment and being near others using CrossFit SFS facilities and equipment, and to the maximum extent permitted by law release and agree to hold CrossFit SFS harmless from any and all causes of action, claims, demands, damages, costs, expenses and compensation for injury, illness, damage or loss to myself and/or property that may be caused by any act or failure to act (including ordinary negligence) of CrossFit SFS, or that may otherwise arise in any way in connection with any services received or my presence at any CrossFit SFS facility.
• I understand that this liability release and waiver supplements and does not replace or reduce any liability release and/or waiver I have previous agreed to, such as in my CrossFit SFS membership agreement.
I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS “INFORMED CONSENT FORM” I AM WAIVING CERTAIN LEAGAL RIGHTS (INCLUDING THE RIGHT TO SUE) WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTERS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION.