STRIVE Physical Activity Readiness Questionnaire / Waiver

Informed Consent / Assumption of Risk:

 

I am aware that there are significant risks involved in all aspects of physical training.  I understand that the reaction of the heart, lungs and vascular system to exercise cannot a always be predicted with accuracy.  I understand that there is a risk of certain abnormal changes occurring during or following exercise which may include abnormalities of blood pressure or heart rate; chest, arm or leg discomfort; transient light-headedness or fainting; and in rare instances, heart attack, stroke or even death.  Excessive work can result (in rare cases) in exertional rhabdomyolosis.  I should look for signs of excessive soreness, darkened urine, and pain in the kidney areas in the days following a particularly intense workout.  While this type of injury is relatively rare, it can occur due to a number of factors, including (but not limited to) genetic predisposition or dehydration, that may be beyond the control of my trainer.  I understand that the programs and classes offered by STRIVE Fitness and Performance are of a nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities.  These risks include, but are not limited to: falls which can result in serious injury or death, injury or death due to negligence on the part of myself, my training partner, or other people around me, injury or death due to improper use or failure of equipment. I am aware that any of these risks may result in serious injury or death to myself and or my partner(s).

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PAR-Q & Informed Consent / Waiver

 

I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in STRIVE Fitness and Performance programs/classes and accept full responsibility for any injury or death that may result from participation in any activity, class or physical fitness program.  I herby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by STRIVE Fitness and Performance.  With my full understanding of the above information, I agree to assume any and all risk associated with my participation in STRIVE Fitness and Performance programs/classes.

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 By signing this document, I acknowledge that I have voluntarily chosen to participate in a program of progressive, physical exercise.  By sigBoential for unusual, but possible, physiological results including, but not limited to, abnormal blood pressure, rhabdomyolosis, fainting, heart attack, or death.  By signing this document, I assume all risk for my health and well-being and hold STRIVE Fitness and Performance, as well as its owners, employees, and other authorized agents incluBding independent contractors, harmless there from.  I understand that questions about exercise procedure and recommendations are encouraged and welcome. 

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Waiver and Release:

I fully understand that my personal exercise program may be strenuous and I choose to participate voluntarily.  I accept all responsibility for my health and any results, injury or mishaps that may affect my well-being or health in any way. I waive any claims, demands, causes of action or any claims for relief whatsoever against, and release STRIVE Fitness and Performance (as well as any of its owners, employees, or other authorized agents, including independent contractors) from any and all liability, claims and/or causes of action that I may have for injuries or other damages, arising out of participation in STRIVE Fitness and Performance activities, including, but not limited to the personal training / nutritional programs and programs/classes.               

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Photo/Video Release: I hereby grant STRIVE Fitness and Performance permission to use my photograph/video image in any and all publications for STRIVE Fitness and Performance, including web site entries, without payment or any other consideration in perpetuity. I hereby authorize STRIVE Fitness and Performance to edit, alter, copy, exhibit, publish or distribute all photos and images. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my photo appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video images. I hereby hold harmless and release and forever discharge STRIVE Fitness and Performance from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of on behalf of my estate which may have or may have by reason of this authorization.

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I agree that when taking classes in STRIVE Studio, that even with clear instruction, there is a possibility of injury, and that it is my responsibility to consult a physician regarding my ability to participate before coming to hot yoga at STRIVE. I attest that I have no psychological, medical or emotional condition that would prevent me from safe participation in a hot yoga class or other heated fitness classes. I release and discharge STRIVE Fitness and Performance, its directors, and STRIVE yoga instructors from any and all liability, claim, demand or action that I may have resulting from injury, death or damages arising from my participation in any of the studio classes, including loss that may be caused by the negligence of the released party.

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Indemnification: I recognize that there is risk involved in the types of activities offered by STRIVE Fitness and Performance. Therefore I accept financial responsibility for any injury that I may cause either to myself or to any other participant due to his/her negligence. 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 agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless STRIVE Fitness and Performance, their principals, agents, employees, and volunteers from 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 STRIVE Fitness and Performance.

 

I have fully read and fully understand the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.

 

I have carefully read this Agreement and fully understand its contents.  I am aware that this is a release and waiver of liability and sign it knowingly, voluntarily, and of my own free will.

Who will be participating?

Adult  Adult and Children  Children

Signee Information

Physical Activity Readiness Questionnaire

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.