Informed Consent And Release Of Liability Agreement printable pdf download

Informed Consent and Release of Liability Agreement

INFORMED CONSENT AND ASSUMPTION OF RISK

I, _______________________________________________ , declare that I intend to use some or all of the

activities, facilities, and equipment offered by the SEIU fitness center at the location indicated at the end of

this Agreement (the “Fitness Center”), and I understand that each person, (myself included), has a

different capacity for participation and use of such activities, facilities, and equipment.

I understand that part of the risk involved in undertaking any exercise activity or program is relative to my

own state of fitness or health (physical, mental, or emotional) and to the awareness, care, and skill with

which I conduct myself in that activity or program. I understand and am aware that exercise activities,

facilities, and equipment, and the use thereof, are a potential hazardous activity. I acknowledge that my

choice to participate in, and use, any activities, facilities, and equipment offered by the Fitness Center

brings with it my assumption of those risks or results stemming from this choice and the fitness, health,

awareness, care, and skill that I possess and use.

I recognize that by participating in the activities, facilities, and equipment offered by the Fitness Center, I

may experience potential health risks and danger such as transient light-headedness, fainting, and

abnormal blood pressure, disorders of heart rhythm, chest discomfort, leg cramps, nausea, heart attack, and

even death. I also understand that there is risk of injury such as a pulled muscle, sprained ankle, or a

stress fracture. I acknowledge my obligation to stop or delay my participation in, and use of, the activities,

facilities, and equipment offered by the Fitness Center should I experience any pain, discomfort, fatigue, or

any other symptoms that I may suffer before or during my participation.

I understand that the Fitness Center does not have any staff present within the Fitness Center, and that

the Fitness Center activities, facilities, and equipment are self-directed in nature. I further understand that

activities, if any, which may be offered by the Fitness Center, are sometimes conducted by individuals

who may not be licensed, certified, or registered instructors or professionals. I accept the fact that the skills

and competencies of such individuals will vary according to their training and experience, and that there is

potential hazard and risk engaging in activities conducted by such individuals.

I declare that I am voluntarily participating in the activities, facilities, and equipment offered by the

Fitness Center with knowledge of the dangers involved. Knowing all these risks, it is still my desire to

participate in, and use, the activities, facilities, and equipment offered by the Fitness Center. I hereby

agree to expressly assume and accept any and all risks of injury or death.

RELEASE OF LIABILIY AND CONVENANT NOT TO SUE

IN CONSIDERATION OF BEING ALLOWED TO USE THE FITNESS CENTER AND ITS

ACTIVITIES, FACILITIES, AND EQUIPMENT, I DO HEREBY WAIVE, RELEASE,

FOREVER DISCHARGE, AND COVENANT NOT TO SUE THE SEIU OR 1800 MASS

AVE. CORPORATION, AND ALL OF THEIR DIRECTORS, OFFICERS, EMPLOYEES,

AGENTS, SUCCESSORS AND ASSIGNS WITH RESPECT TO ANY AND ALL CLAIMS,

DEMANDS, ACTIONS, OR CAUSES OF ACTION WHATSOEVER, INCLUDING CLAIMS

ARISING FROM THE NEGLIGENCE OR MALPRACTICE OF ANY PERSON OR PARTY,

INCLUDING SEIU AGENTS OR EMPLOYEES, AND FROM ANY AND ALL LIABILITY

FOR ANY LOSS OR PROPERTY DAMAGE OR PERSONAL INJURY OF ANY KIND,

Page 1 of 2

Informed Consent And Release Of Liability Agreement