Hale Kids Waiver Crossfit Hale (Page 2 of 2) in pdf

Do you know any reason why your child should not participate in physical activity? Yes or No: ___________

If yes, please explain: ____________________________________________________________________

Doctor’s Name: ____________________________________ Phone:______________________________

I, the undersigned, do hereby verify that all of the above information is true and correct.

_________________________________________________________________

______________

Parent/Guardian Signature

Date

Waiver and Release of Liability: Workshop Fitness DBA CrossFit Hale

Health Notification

CrossFit Hale/Hale Kids & Teens services are not a substitute for professional medical advice or a medical examination. Prior to

participation in any program, activity or exercise you should seek the advice of your physician or other qualified health-care

professional. You understand that these exercises can be strenuous and should be done in moderation. There is an inherent risk in any

exercise that, while providing health benefits, can also cause unknown health issues. Application or reliance on the techniques, advise,

ideas and suggestions of any person associated with CrossFit Hale/Hale Kids & Teens are at the sole discretion and risk of the

participant and his/her parents and guardians.

Waiver

I agree, by allowing my child(ren) to participate in any program associated with CrossFit Hale, that CrossFit Hale/Hale Kids & Teens

shall not be liable to any direct, indirect, special consequential or exemplary damages for any and all injury and/or harm to you and/or

your child incurred in or around the property where exercise occurs. I willingly assume full responsibility for the risks that I am exposing

my child(ren) to and accept full responsibility for any and all injury or death that may result from his/her participation in any and all

activity or class facilitated by CrossFit Hale.

Release

In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily allowing my

child(ren)’s participation in the activities available at CrossFit Hale, I hereby release CrossFit Hale/Hale Kids & Teens, their principals,

agents, employees and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out

of, or are in any way connected with my child(ren)’s participation in this activity, including those allegedly attributed to the negligent acts

or omissions of the above mentioned parties. I, the undersigned acknowledge that my child(ren) has no physical impairments or

illnesses that will endanger him/her or others.

In case of an Emergency

I give full permission for any person connected to CrossFit Hale/Hale Kids & Teens to administer first aid deemed necessary, and

in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a

medical facility deemed necessary for the well-being of the child.

Photography/Video Release

Participants involved in any activities offered by CrossFit Hale may be photographed or videotaped during training. The undersigned

hereby consents to the use of these photographs and/or videos without consent or compensation on the CrossFit Hale website and

Facebook page or in any editorial, promotional or advertising material produced by CrossFit Hale/Hale Kids & Teens.

Indemnification

I recognize that there is a risk involved in the types of activities offered by CrossFit Hale/Hale Kids & Teens. I therefore accept any and

all financial responsibility for any and all injury that my child(ren) or I may cause either to myself or to others. 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 will

reimburse them for such fees and costs. I agree to indemnify and hold harmless CrossFit Hale/Hale Kids & Teens, their principals,

agents, employees, and volunteers from any and all 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 CrossFit Hale/Hale Kids & Teens.

Acceptance

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT

THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL AND CONSENT.

_____________________________ ___

____________________________________________ ______

PRINT NAME of Parent/Guardian

Parent/Guardian Signature

Today’s Date

Hale Kids Waiver Crossfit Hale Page 2

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