In consideration of CrossFit 4551 (CF4551) allowing me to participate in its activities, I acknowledge, understand and am aware of the following:
I have voluntarily chosen to participate in training activities provided by CF4551. I understand that there are inherent risks in all aspects of physical training and acknowledge that 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 have been advised to limit my effort in order to minimise the risk associated with this condition.
I understand that the training may involve weightlifting, gymnastics movements, strenuous body weight exercises and other high exertion activities, and that I am not obligated to perform or 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 session.
I understand that should I feel lightheaded, faint, dizzy or nauseated or experience any pain or discomfort, I am to stop the activity and inform the trainer. I give CF4551 and its staff full permission to seek emergency medical services for me should I become injured or ill with the understanding that I am responsible for any medical expenses incurred.
I agree to waive any and all claims that have or may have in the future against CF4551. I agree to release CF4551 from any/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 CF4551, due to any cause whatsoever, including negligence, breach of contractor breach of any statutory or other duty of care. I agree to hold harmless and indemnify CF4551 from any liability for any damage to the property of, or personal injury to, any third party resulting in my participation in any program, activity or service provided by CF4551.
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, I also give full permission for any person connected with CF4551 to administer any first aid deemed necessary, and in the 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.
Use of picture(s)/film/likeness: I agree to allow CF4551 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 for said purposes, I agree that I must inform staff of this in writing.
I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS INFORMED CONSENT FORM, I AM WAIVING CERTAIN LEGAL RIGHTS (INCLUDING THE RIGHT TO SUE) WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTOR, ADMINISTERS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES.
ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION.
WARNING - SAFETY FIRST
HIGH INTENSITY EXERCISE MUST BE APPROACHED CAUTIOUSLY IN THE BEGINNING, A GRADUAL RAMP UP OF INTENSITY IS NECESSARY TO ALLOW MUSCLES TO ADAPT TO THE NEW DEMANDS BEING PLACED ON THEM. FAILURE TO DO SO OPENS THE DOOR TO LIFE THREATENING CONDITIONS, NAMELY RHABDOMYOLYSIS, IN SHORT, THE MUSCLE CELLS ARE DAMAGED, FLOODING THE BLOODSTREAM WITH TOXINS THAT OVERWHELM THE KIDNEYS AS THEY ATTEMPT TO CLEANSE THE BLOOD LEADING TO POTENTIAL SHUT DOWN, CROSSFIT CAN CAUSE RHABDOMYOLYSIS AND IT IS IMPORTANT THAT YOU START AT REDUCED INTENSITY, BROWN URINE, COMPLETE MUSCLE WEAKNESS AND/OR SWELLING OF JOINTS ARE WARNING SIGNS OF "RHABDO". IF YOU DEVELOP THESE SYMPTOMS, WE ADVISE THAT YOU SEEK MEDICAL ASSISTANCE IMMEDIATELY.