Fillable Fitness Waiver Form (Page 2 of 2) in pdf

TOP NOTC H FITNESS A ND B OX ING

Waiver For m

WAIVER/RELEASE AGREEMENT

Understand that there are risks and dangers inherent in participating and/or

receiving instruction in (Personal Training, Women’s Kickboxing, Thai Boxing, Boxing and Aerobics Classes)

hereinafter "Activity". I also understand that in order to be allo wed to participate and/or receive instruction

in Activity; I must give up my rights to hold Top Notch Fitness and Boxing instructors liable for any injury or

damage which I may suffer while participating and/or receiving instruction in Activity. Kno wing this, and in

consideration of being permitted to participate and/or receive instruction in Activity, I hereby voluntarily

release Top Notch Fitness and Boxing instructors from any and all liability resulting from or arising out of my

participation and/or receipt of instruction in Activity. As participant in a program or activity Top Notch

Fitness (or as a parent or guardian of a participant), I hereby Top Notch permission to use my or my child

image, video form, or voice photograph, video tapes, internet website or other materials prepared or

released by Top Notch from time to time, for promotional, safety or instructional purposes. I understand

and agree that I am releasing not only the entities set forth in the paragraph above, but also the officers,

instructors, participants and property o wners of those entities.

I understand and agree that this Waiver/Release will have the effect of releasing, discharging, waiving and

forever relinquishing any and all actions or causes of action that I may have or have had, whether past,

present or future, whether kno wn or unkno wn, and whether anticipated or unanticipated by me, arising

out of my participation and/or receipt of instruction in Activity with the Top Notch Fitness and Box ing

instructors, its officers, property o wners or instructors. I understand and agree that this Waiver/Release

applies to personal injury, property damage, or wrongful death, which I may suffer, even if caused by the

acts or omissions of others. I understand and agree that by signing this Waiver/Release, I am assuming full

responsibility for any and all risk of death or personal injury or property damage suffered by me while

participating and/or receiving instruction in Activity.

I understand and agree that this Waiver/Release will be binding on me, my spouse, my heirs, my personal

representatives, my assignees, my children and any guardian for said children. I understand and agree that

by signing this Waiver/Release, I am agreeing to release, indemnify and hold Top Notch Fitness and Boxing

instructors, its officers, instructors, property o wners or active participants harmless from any and all liability or

costs, including attorney’s fees, associated with or arising from my participation and/or receipt of instruction

in Activity. I understand and agree that if I am signing this Waiver/Release on behalf of my minor child, that

I will be giving up the same rights for said minor, as I would be giving up if I signed this document of my

o wn behalf. I ackno wledge that I have read this Waiver/Release Agreement and that I understand the

w ords and language in it. I have been advised of the potential dangers incidental to participating and/or

receiving instruction in Activity.

Print Name: ___________________________________________________________________

Participant / Member

Date of Birth

Signature: ___________________________________________________________________

Parent/Guardian Release:

I am the parent or legal guardian of the minor

_____________________________________________,

and I am signing this Waiver/Release on behalf of said minor.

Print Name of Parent: ______________________________________________________________

Signature of Parent: ______________________________________________ Date: ____________

Fitness Waiver Form Page 2

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