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Gym & Fitness Liability Waiver
Emergency contact first name
Emergency contact last name
Emergency contact phone
Please specify anything we should know about
Do you have a doctor’s permit to participate in intense physical activities?
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
I acknowledge and agree that Athletic Society, Bend and their employees are not a medical professional and do not provide any medical diagnoses or treatments. I agree that if I have any medical condition, I will seek the help of a medical professional
I declare that the info I’ve provided is accurate & complete
Thanks for submitting!
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