Informed Consent / Assumption of Risk
I am aware that there are significant risks involved
in all aspects of physical training. I understand that the reaction of the
heart, lungs and vascular system to exercise cannot always be predicted with
accuracy. I understand that there is a risk of certain abnormal changes
occurring during or following exercise which may include abnormalities of blood
pressure or heart rate; chest, arm or leg discomfort; transient
light-headedness or fainting; and in rare instances, heart attack, stroke or
even death. Excessive work can result (in rare cases) in exertional
rhabdomyolosis. I should look for signs of excessive soreness, darkened urine,
and pain in the kidney areas in the days following a particularly intense
workout. While this type of injury is relatively rare, it can occur due to a
number of factors, including (but not limited to) genetic predisposition or
dehydration, that may be beyond the control of my trainer. I understand that
the programs and classes offered by RM Fitness, Inc. are of a nature and kind
that are extremely strenuous and can/may push me to the limits of my physical
abilities. 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. 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 to which I am exposing myself as a result of my participation in RM
Fitness, Inc., Inc programs/classes and accept full responsibility for any
injury or death that may result from participation in any activity, class or
physical fitness program. 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 RM Fitness, Inc. With my full understanding of
the above information, I agree to assume any and all risk associated with my
participation in RM Fitness, Inc. programs/classes.
By signing this document, I acknowledge that I have
voluntarily chosen to participate in a program of progressive, physical
exercise. By signing this document, I acknowledge being informed of the
strenuous nature of the program and the potential for unusual, but possible,
physiological results including, but not limited to, abnormal blood pressure,
rhabdomyolosis, fainting, heart attack, or death. By signing this document, I
assume all risk for my health and well-being and hold harmless therefrom RM
Fitness, Inc., as well as its owners, employees, and other authorized agents
including independent contractors. I understand that questions about exercise
procedure and recommendations are encouraged and welcome.
Waiver and Release
I fully understand that my personal exercise program
may be strenuous and I choose to participate voluntarily. I accept all
responsibility for my health and any results, injury or mishaps that may affect
my well-being or health in any way. I waive any claims, demands, causes of
action or any claims for relief whatsoever against, and release RM Fitness,
Inc. (as well as any of its owners, employees, or other authorized agents,
including independent contractors) from any and all liability, claims and/or
causes of action that I may have for injuries or other damages, arising out of
participation RM Fitness, Inc. activities, including, but not limited to
the personal training / nutritional programs and programs/classes.
Media Release
I hereby grant RM Fitness, Inc. permission in
perpetuity to use my photograph/video image in any and all publications for
CrossFit or RM Fitness, Inc., including web site entries, without payment or
any other consideration. I hereby authorize RM Fitness, Inc. to edit, alter,
copy, exhibit, publish or distribute all photos and images. I waive the right
to inspect or approve the finished product, including written or electronic
copy, wherein my photo appears. Additionally, I waive any right to royalties or
other compensation arising or related to the use of the photograph or video
images. I hereby hold harmless and release and forever discharge RM Fitness,
Inc. from all claims, demands, and causes of action which I, my heirs,
representatives, executors, administrators, or any other persons acting
on my behalf or on behalf of my estate which may have or may have by
reason of this authorization.
Indemnification
I recognize that there is risk involved in the types
of activities offered by RM Fitness, Inc. Therefore I accept financial
responsibility for any injury that I may cause either to myself 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 RM Fitness, Inc., 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 RM Fitness, Inc.
I have fully read and fully understand the foregoing
assumption of risk and release of liability, and I understand that signing it
obligates me to indemnify the parties named for any liability for injury or
death of any person and/or 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.
I have carefully read this Agreement and fully
understand its contents. I am aware that this is a release and waiver of
liability and sign it knowingly, voluntarily, and of my own free will.
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