Youth Code of Conduct Waiver Form

I hereby agree to the following guidelines set forth to me by the Pacific Institute for Sport Excellence (PISE), and agree that if these guidelines are not followed, my membership and access to this facility will be become void without warning. I understand that I am being granted special permission to use this facility, due to my age, and that those privileges are to be respected.


1. I will treat facility equipment with the upmost care and respect in order to prevent any undue wear and tear or potential damage.

2. I will conduct myself in an appropriate and mature manner making sure to respect other members as well as the staff.

3. I will not participate in any type of playing around at any time while in the gym area to ensure the safety of myself and others.

4. If I am unsure of any rules or regulations within the facility I will promptly ask a staff member to ensure my understanding.

5. I will not engage in lifting any excessive loads and be sure to strictly follow the programming prescribed to me by the qualified PISE staff.

6. I will follow COVID 19 protocols in place at PISE and required by the Provincial Health Officer. (As these protocols are fluid, please visit for further COVID 19 information.)


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Signee Information

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.