Physical assessment readiness questionnaire
I agree to participate in one or more physical fitness program(s)/class(es) sponsored by CrossFit Leicester Ltd, which may include, but not necessarily be limited to CrossFit training. I am fully aware that the fitness programs/classes which CrossFit Leicester Ltd offers and in which I desire to participate are of nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities. I the undersigned recognise and understand that the programs/classes are not without varying degrees of risk which may include, but are not limited to the following:
Injury to the musculoskeletal and/or cardiorespiratory systems 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, or injury or death due to a medical condition, whether known or unknown by me. 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 any and all risks that I am exposing myself to as a result of my participation in CrossFit Leicester Ltd. programs/classes. I hereby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by CrossFit Leicester Ltd . I, the undersigned, am aware that there exists the possibility of adverse physical changes during an exercise program, these changes could include abnormal blood pressure, fainting, disorder of heart rhythm, stroke, and in very rare instances, heart attack or even death. With my full understanding of the above information, I agree to assume any and all risk associated with my participation in CrossFit Leicester Ltd fitness programs/classes.
In full consideration of the above-mentioned risks and hazards and in full consideration of the fact that I am willingly and voluntarily participating in the activities made available by CrossFit Leicester Ltd, and with my full understanding of all of the above, I hereby waive, release, remise and discharge CrossFit Leicester Ltd and its agents, officers, principals and employees and volunteers, of any and all liability, claims, demands, actions or rights of action, or damages of any kind related to, arising from, or in any way connected with, my participation in CrossFit Leicester Ltd fitness programs/classes, 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 Leicester Ltd 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 well being of the child.
Indemnification: I recognise that there is risk involved in the types of activities offered by CrossFit Leicester Ltd. Therefore I accept financial responsibility for any injury that I or 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 Leicester Ltd, 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 Leicester Ltd at the main building or abroad. This includes but is not limited to; Parks, Recreational areas, Playgrounds, Areasin the vicinity of the main building, and/or any area selected for training by CrossFit Leicester Ltd.
Photography/Video Release: Participants involved in any activities offered by CrossFit Leicester Ltd its agents, officers, principals, employees and volunteers may take photographs or videotape participants during training, may use picture(s), film and/or likeness of me found on social media platforms / instagram/ Twitter/ Google etc. The undersigned hereby consents to the use of these photographs, images and/or videos without compensation, on CrossFit Leicester Ltd website or in any editorial, promotional or advertising material produced and/or published by CrossFit Leicester Ltd. online, on any social media platforms, instagram etc or on/in print medium