Youth Fitness Waiver & Release Of Liability printable pdf download

YOUTH FITNESS WAIVER & RELEASE OF LIABILITY

This form is an important legal document. It explains the potential risk associated with an exercise program as it

relates to your child. It is critical that you read and understand it completely. After you have done so, please print

your name legibly and initial in the spaces provided and sign name at the bottom.

WAIVER & RELEASE OF LIABILITY

I, ______________________________, have volunteered to participate in a program of physical exercise under the

(Child’s name)

direction of Live Well Personal Training which will include, but may not be limited to, weight (resistance)training, assorted

games, movement, flexibility and other assorted exercise skills and drills (i.e. jumping, running, skipping, hopping,

throwing, rolling, bouncing, etc) . In consideration of Live Well Personal Training’s agreement to instruct, assist, and

train______________________________, I, on behalf of myself, my heirs, and

(Child’s name)

executors, covenant not to sue Live Well Personal Training, and do here and forever release and discharge and hereby

hold harmless Live Well Personal Training’s 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. __________

(Parent or Guardian Initials)

ASSUMPTION OF RISK

I, ______________________________, recognize that exercise might be difficult and strenuous and that there could

(Child’s name)

be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical

changes during exercise does exist. These changes include, but are not limited to, abnormal blood pressure, fainting,

disorders in heartbeat, heart attack, and in extremely rare instances, death. __________

(Parent or Guardian Initials)

Although, trainer will take precautions to ensure safety, I expressly assume and accept sole responsibility for my safety. I

understand that as a result of my participation in an exercise program, my child could suffer any injury or physical disorder

that could result in becoming partially or totally disabled and incapable of performing any gainful employment or having a

normal social life. _________

(Parent or Guardian Initials)

I recognize that an examination by a physician should be obtained by all participants prior to involvement in any exercise

program. If I have chosen not to obtain a physician's permission prior to beginning this exercise program with Live Well

Personal Training, I hereby agree that I am doing so at my own risk. _________

(Parent or Guardian Initials)

In all cases, circumstances, situations, events and locations, I acknowledge and agree that I assume the risks associated

with any and all activities and/or exercises in which my child participates.__________

(Parent/Guardian Initials)

I acknowledge and agree that no warranties or representations have been made to me or my child regarding the results I

will achieve from this program. I understand that results are individual and may vary.

__________________________________________

________________________________

Parent or Guardian’s Signature

Date

__________________________________________

________________________________

Print Name (Parent or Guardian)

Emergency Phone

___________________________________________________

________________________________

Email Address

Participant’s Age

Youth Fitness Waiver & Release Of Liability

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