CrossFit Buntingford
Waiver & Health Info
Unit 8 the Firs, Watermill Estate, Buntingford, Hertfordshire, SG99JS
Name: __________________________________________________________
Email: _______________________________________________________________
Address: __________ _______________________________________________________ Date of Birth: ______________________ Home Ph : _______________________________
Mobile: ________________________________
In an emergency, I would like CrossFit Buntingford to Call: __________________________________________ Phone: ___________________________________
Health Questions Do you: Smoke? Y N Drink alcohol? Y N Take prescription meds? Y N Are you exercising now? Y N How many times per week? _______ Do you play sports? Y N Do you have: Back pain, Knee pain or Shoulder pain? Y N Previous Injuries or Surgeries? Y N High blood pressure, Asthma, Diabetes, or a Heart condition? Y N
Any other health conditions not listed? Y N __________________________________________________________________________________________________________________________________________________________________________
Reviewer Notes: __________________________________________________________________________________________________________________________________________________________________________
Photography/Video Release: Participants involved in any activities offered by CrossFit Buntingford may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the CrossFit Buntingford website or in any editorial, promotional or advertising material produced and/or published by CrossFit Buntingford.
Waiver and Release of Liability Express assumption of risk:
I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; strains and sprains. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of CrossFit Buntingford.
I acknowledge that I have no physical impairments, injuries, or illnesses that will endanger me or others.

Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by CrossFit Buntingford. I, the undersigned hereby release CrossFit Buntingford, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. 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 Buntingford 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 wellbeing of the child. Indemnification: The participant recognizes that there is risk involved in the types of activities offered by CrossFit Buntingford. Therefore, the participant accepts financial responsibility for any injury that the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless CrossFit Buntingford, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by CrossFit Buntingford, at the main building or abroad. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by CrossFit Buntingford. I have read and understood the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.

Please understand that despite all the precautions that you, other members, and/or CrossFit Buntingford may take, we cannot guarantee your health or safety, and you may still be exposed to COVID-19, including through interactions with other individuals who have COVID-19. By executing this release and gaining access to the facility, you, on behalf of yourself, your heirs, beneficiaries, representatives, successors and assigns: (1) voluntarily assume all risks associated with any exposure to COVID-19, including, but not limited to suffering any type of medical condition, illness and, potentially, death; and (2) knowingly and voluntarily waive, release, covenant not to sue, forever discharge, indemnify, and hold harmless CrossFit Buntingford and their respective officers, directors, employees, contractors, agents, representatives, successors and assigns (“Released Parties”) from any and all liability, damages, losses, suits, demands, causes of action to the fullest extent permitted by the laws of this state, or any other claims of any nature whatsoever, arising out of or relating in any way to your use of the facility and your potential exposure to COVID-19.

 
Cancellation and Pausing of memberships
I understand that I am required to give 30 days Notice for either cancellation, pausing or membership changes of monthly memberships plans.
If you decide to reactivate your membership in the future (and we hope you do). Membership rates in effect at the time of reactivation will be applicable as membership rates are subject to change.

To cancel your membership, we require written notice at least 30 days in advance, via the form on our website. If a scheduled payment is due within 30 days of your cancellation notice, that payment will still be charged in FULL. This ensures we can manage class availability and member spaces fairly. No refunds will be issued for payments already processed. Your membership will remain active until the end of the paid period.
*please note we do not pause for holidays.

Use of the premises outside coaching hours
If entering the premises to do a workout outside the current class schedule the following criteria must be adhered to:
1. Use the key pad to enter the building. NOTE Only current members are allowed in the premises at these times.
2. No children are to accompany adults while they are using open gym.
3. Do not train under any circumstances when under the influence of alcohol.
4. Fill out the signing in book in the reception area with time of entry and time of leaving.
5. Warm Up Properly
Always take time to prepare your body before lifting or intense training.
6. Use Proper Technique
Stick to movements you know how to perform safely — and scale if needed.
7. If working alone make sure you do not attempt unsafe movements that require a support person, such as one repetition lifts.
8. Push yourself, but don’t go to failure on big lifts or risky movements without a spotter.
9. Return all equipment to the place you got it from (including rig hooks which should be removed when not in use).
10. Before exiting, you are responsible for ensuring that the fire door at the back of the unit and the shutter door are closed. To exit the building use the button on the wall close to the door as illustrated in the pictures below.
11. In the event of an emergency, use the green emergency exit button by the front door or use the fire door at the back of the unit.
12. CCTV is in use at all times for your safety and security reasons.
13. If you need to get changed, please use the toilet.
Note that in the event of a power black out, the emergency exit signs will illuminate, lighting your way out.
Exit the building and let the management know as soon as possible, so the premises can be secured. Call Mick on 07912 653164 or Alison on 07792 268433 in this event.

Sign________________________
Print_______________________
Date_________________
 
In the event of an emergency please call either
Mick 07912653164 Alison 07792268433
Ben 07469711889
Or Hannah 07557511611