Waiver, Release, and Assumption of Risk Form
This form is an important legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. It is critical that 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. This is a waiver, informed consent, and covenants not to sue. I am volunteering to participate in a program of physical exercise under the direction of The 12, Inc. which will include, but may not be limited to nutrition, weight and resistance training. In consideration of The 12, Inc. agreement to instruct, assist, and train me, I do hereby forever release, discharge, and hold harmless The 12, Inc. and their respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical change during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in heartbeat, heart attack and in rare instances, death. I understand that because of my participation in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of possible gainful employment or having a normal social life. I recognize that an examination by a physician should be obtained by all participants prior to involvement in any exercise program, and hereby agree to such prior to my participation in the program.
I have chosen not to obtain a physician’s permission prior to beginning this exercise program with The 12, Inc.; I hereby agree that I am voluntarily and knowingly 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. I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12, Inc. for your negligence or that of your employees, agent or contractors.