Agreement, Release and Waiver of Liability Disclaimer:

You should always consult with your doctor before beginning any type of exercise or physical liability.

This form is an important legal document. It explains the risks you are assuming by beginning an exercise program. It is critical you read and understand it completely. After you have done so, please print your name legibly and sign in the spaces provided at the bottom.

Waiver, Informed consent, and covenant not to sue:

I have volunteered to participate in a session, course or program containing physical exercise under the direction of CF 4TC Ltd T/A CrossFit 4TC, but may not be limited to weight/or resistance training. In consideration of CF 4TC Ltd T/A CrossFit 4TC, agreement to instruct, assist, and train me, I do here release and discharge and hereby hold harmless CF 4TC Ltd T/A CrossFit 4TC, and their respective agents, heirs, assigns, contractors and employees from any and all claims, demands, damages, rights or causes of action, present and future, arising out of or connected with my participation in this or any program including any injuries resulting from them. This waiver and release from liability includes, without limitation, injuries which may occur as a result of (1) my use of all amenities and equipment in CrossFit 4TC's possession, and facilities or premises in which the session takes place, and my participation in any activity, program, personal training or instruction (2) Equipment that may malfunction or break (3) their negligent instruction or supervision (4) any slipping and/ or falling dropping of equipment while on the premises.

Assumption of Risk

To my best knowledge I am in good physical condition and have no disease, physical limitation, health concern or injury that would be aggravated or would be the cause of any injury sustained, before, during or as a result of my participating in activities related either directly and/ or indirectly to CF 4TC Ltd T/A CrossFit 4TC.

I recognise that exercise might be difficult and strenuous and there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure; fainting; disorders in heartbeat; heart attack; and, in rare instances, death.

I understand that as a result of my participation in an exercise or other program, I could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life.

I recognise that an examination by a physician should be obtained by all participants prior to involvement in any exercise or physical program. If I have chosen not to obtain a physician’s permission prior to beginning this exercise or physical program with CF 4TC Ltd T/A CrossFit 4TC, I hereby agree that I am doing so at my own risk.

In any event, I acknowledge and agree that I assume the risks associated with any and all activities and/ or exercises in which I participate.

I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this program. I understand that results are individual and may vary.

Physical Activity Readiness Questionnaire (PAR-Q) and you
(a questionnaire for people aged 15 - 69)

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.

If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR­Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.

If you answer YES to one or more questions: Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR­Q and which questions you answer YES. You may be able to do any activity you want ­ as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice. Find out which community programmes are safe and helpful for you If you answer NO to all questions: If you answer NO honestly to all PAR­Q questions, you can be reasonably sure that you can: Start becoming much more physically active ­ begin slowly and build up gradually. This is the safest and easiest way to go. Take part in a fitness appraisal ­ this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active. DELAY BECOMING MUCH MORE ACTIVE: If you are not feeling well because of a temporary illness such as a cold or a fever ­ wait until you feel better; or If you are or may be pregnant ­talk to your doctor before you start becoming more active. PLEASE NOTE: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan. NO CHANGES PERMITTED. YOU ARE ENCOURAGED TO PHOTOCOPY THE PAR­Q BUT ONLY IF YOU USE THE ENTIRE FORM. NOTE: If the PAR­Q is being given to a person before he or she participates in a physical activity programme or a fitness appraisal, this section may be used for legal or administrative purposes. “I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.”