Workshop and Class Form and Waiver

Workshop and Class Form and Waiver

Please note that payment must be received in order to reserve your spot in the workshop or class. In addition, this form must be completed prior to the workshop.
Select the workshop or class you are registering to attend:*

Female Athlete Workshop at CrossFit ClemsonCore/Pelvic Floor (Taylors/Greenville)Other
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
If you feel comfortable sharing, please share if you have/had diastasis recti, pelvic floor dysfunction, leaking, or prolapse and your experience.
Have you been cleared for exercise by your doctor?*

yesno
Do you have any medical conditions that I need to be aware of? If so, please provide more information.*
Please provide an emergency contact(name and phone #)*

Fitness Services Waiver

I hereby agree that by signing this document, I consent to waive certain legal rights, including the right to sue the following party, and, if applicable, its owners, trainers, representatives, and facilities from any physical, material, tangible or intangible, loss or damages that may happen to me during my participation in this workshop (hereinafter, "Fitness Services") undertaken while under their instruction or thereafter of Ashley Heringa/Strength in Her Fitness LLC.

I will be voluntarily participating in the Fitness Services that will be conducted by the Ashley Heringa/Strength in Her Fitness LLC. These Fitness Services will include, but not be limited to the following:

The following is the identifying and contact information of the Fitness Provider and host gym:

Business Name:

Strength in Her Fitness LLC 510 E Main St, Pendleton, SC 29670

8642091897

Host Gym refers to the gym or location of the workshop, class or training takes place.

My signature below indicates that I agree with and understand the following:

It is my responsibility to consult a physician before participating in this or any fitness program and I affirm that I have no medical conditions that would restrict me from participating in any of the Fitness Services.

I agree to hold Ashley Heringa/ Strength in Her Fitness/Host gym, and if applicable, its owners, trainers, and representatives, harmless from any damage, whether tangible or intangible, that may happen to me while participating in the Fitness Services. Such injuries may include, but are not limited to, muscle strains, muscle sprains, muscle spasms, heart attacks, raised blood pressure, and broken, fractured, or dislocated bones.

I agree that Ashley Heringa/ Strength in Her Fitness/host gym offers the Fitness Services with no guarantee of results. I agree that I am solely responsible to maintain the diet and fitness regime appropriate for my level of health and stamina, and I agree that any results that occur, whether positive or negative, are the effects of my own personal choices.

I agree that participation in the Fitness Services is not a replacement for actual medical care, and that if I do experience medical issues, I will contact my doctor immediately. I agree that information provided in these workshops are not a substitute for the advice of a medical professional or physical therapist.

I agree and verify that all of the information that I have given Ashley Heringa/ Strength in Her Fitness LLC/Ehost gym and its representatives is accurate, up-to-date, and without the omission of any known medical issues.

I agree and verify that If I have omitted any necessary personal information, whether knowingly or unknowingly, I will hold the Fitness Provider harmless against all liability for any damages that may occur to myself or to others because of my actions or inactions.

I agree to keep the Ashley Heringa/ Strength in Her Fitness LLC/host gym apprised of any changes or upcoming changes concerning my physical health and personal information.

I understand and agree that it is my responsibility to let the Ashley Heringa/ Strength in Her Fitness/host gym know if I find myself in any pain or discomfort before, after, or during the Fitness Services.

If I do require medical treatment or attention while or after participating in the Ashley Heringa/ Strength in Her Fitness LLC/host gym, I agree that the medical costs are mine and mine alone and hold the Fitness Provider blameless from any charges, fees, or costs that my conditions may incur.

This Fitness Services Waiver will bind and be enforceable against me and all of my personal representatives. I agree that this Fitness Services Waiver should be enforceable to the fullest extent of the law, and if any portion is held invalid, the remainder should continue in full legal force and effect.

I specifically acknowledge and agree that this document is not intended to be a general release, which would be limited under some state and local laws.

This Fitness Services Waiver shall be construed and interpreted as broadly as possible in the applicable jurisdiction.

ASSUMPTION OF RISK. I understand and am aware that my participation in the Fitness Services involves risks. These risks may lead to tangible or intangible harm, and I agree that they may result not only from my own actions but also from the actions of others. With the knowledge and understanding of these risks, I choose, of my own will and volition, to continue participating in the Fitness Services.

I am also aware that there are risks that I may not have considered, yet I waive my right to any claims that may occur from these unconsidered risks and I choose, of my own will and volition, to participate in the Fitness Services.

COVENANT NOT TO SUE. I will not start any lawsuit or other court action against Ashley Heringa/ Strength in Her Fitness LLC/host gym, nor will I join any such proceeding, including any claim for money damages. I acknowledge and agree that I am entering a covenant not to sue Ashley Heringa/ Strength in Her Fitness LLC/host gym in any capacity, including to hold the Fitness Provider liable for any injury, loss, or damage sustained by me or my property, even if it is due to the Fitness Provider's negligence or omission. I also waive the right of any of my insurers' to make any such claim.

INDEMNIFICATION: I agree to defend and indemnify Ashley Heringa/ Strength in Her Fitness LLC/host gym and any of its affiliates (if applicable) and hold them harmless against any and all legal claims and demands, including reasonable attorney's fees, which may arise from or relate to my use or misuse of the Fitness Services or my conduct or actions. I agree that the Fitness Provider shall be able to select its own legal counsel and may participate in its own defense, if desired.

REPRESENTATION: I am over 18 (eighteen) years of age, and am medically and physically able to participate in the Fitness Services.

GOVERNING LAW: This Fitness Services Waiver shall be governed by and construed in accordance with the internal laws of South Carolina without giving effect to any choice or conflict of law provision or rule. Each party irrevocably submits to the exclusive jurisdiction and venue of the federal and state courts located in the following county in any legal suit, action, or proceeding arising out of or based upon this Fitness Services Waiver in Anderson County.

I have read the above Fitness Services Waiver fully and I understand and agree to its contents. I understand and agree that by signing this Fitness Services Waiver I forfeit any right, claim, or ability to hold the Fitness Provider responsible for any tangible or intangible damages, loss of property, or loss of life that may occur during or after my use of the facilities and participation in the Fitness Services.
Signature

Clear
Please Select your class to pay:
prevnext( X )
Female Athlete Workshop$15.00

Core/Pelvic Floor Taylors/Greenville $85.00

Total $0.00
Pay with PayPal

Please click one of the PayPal options to complete payment and submit the form.
Should be Empty: