Waiver

 

GWalker Performance

INFORMED CONSENT FOR PARTICIPATION IN VOLUNTARY EXERCISE PROGRAM

I hereby agree to voluntarily engage in an exercise program and confirm that I have no disabilities, impairments, or ailments that would be adversely affected by my use of the facility; and that if I am under the care of a physician GWalker Performance shall not be held responsible for my compliance with any instructions of my physicians.

I hereby certify that all answers given on the health history questionnaire are correct, and I have reported to GWalker Performance all medical problems/conditions.

I hereby acknowledge the warning of GWalker Performance that before engaging in any vigorous activity, I should have a complete medical examination by a qualified physician to determine if I should observe any personal limitations in undertaking any activity and exercise. I hereby certify that if I should become pregnant I shall obtain a release from my physician before continuing or beginning a program of physical exercise.

If needed, I authorize that GWalker Performance may administer emergency treatment as she deems appropriate under the circumstances before, during, and after any event.

I understand that I shall accept financial responsibility for any injury to myself occurring during GWalker Performance sessions.

I expressly assume all risks and full responsibility for any injuries, damages or losses, including, without limitation, loss of personal property by theft or otherwise, which I may incur during GWalker Performance sessions and I hereby fully and forever release, indemnify, and agree to save harmless discharge GWalker Performance from any and all claims, whether some be known or unknown, anticipated or unanticipated, resulting from or arising out of my participation in training sessions.

Any information obtained in the program is privileged and confidential and will not be revealed without my expressed, written consent. I do, however, agree to the use of educational photographs/videos for research, statistical, and/or advertising purposes.

I certify that any questions I may have had concerning this exercise program have been answered to my satisfaction. I have read this form carefully and fully understand and accept the above terms, regulations, and policies of GWalker Performance.

I have read and understand to the fullest all documentation in order to become a member of GWalker Performance training.

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