Liability Waiver and Release Form
Please read the following carefully and sign where indicated.
I, hereby acknowledge and agree to the following:
Assumption of Risk: I understand that participating in exercise and fitness activities involves risks of injury. I am voluntarily participating in these activities and assume all risks of injury or illness that may result.
Medical Clearance: I have consulted with a physician and am physically capable of participating in a fitness program. I agree to inform my trainer of any changes to my medical condition.
Release of Liability: I hereby release liability from Matthew Mitchell and Katey Rogers at Revive Gyms Limited, its trainers and employees, from any and all claims, demands, damages, or causes of action arising out of or connected to my participation in the fitness program.
Confidentiality: I understand that all personal information provided will be kept confidential and used only for the purposes of designing an appropriate exercise program.
Payment and Cancellation Policy: I understand the payment and cancellation policies as outlined by Matthew Mitchell, Katey Rogers and Revive Gyms Limited.
Consent to Treatment: In the event of a medical emergency, I authorise Matthew Mitchell and Katey Rogers of Revive Gyms Limited, its trainers and employees to seek emergency medical treatment on my behalf.
By signing below, I confirm that I have read and understand this waiver and release, and I agree to be bound by its terms.
Participant’s Signature: _________________________________________
Date: __________________________________________________________
Parent/Guardian Signature (if under 18): __________________________
Date: __________________________________________________________