Participant Form

Thank You for Choosing CrossFit254

Hello,

Welcome to your CrossFit254 class today. We so happy to have you here and we hope you get to enjoy your time with us. Before we get started, we would like to know a little about you so that we can ensure we program your session today to meet your objectives.

Kindly fill out the details below:

Contact Information

Personal History

Any undue chest, joint pain or any other injury (ankle, knee, hip, back, shoulder, etc) that we should know about?
Due to any chest, joint pain or any other injury (ankle, knee, hip, back, shoulder, etc) that we should know about?

Consent

During the class, we may take photos or videos. Kindly confirm your consent for us using this to market CrossFit254.

See our Privacy Policy

Indemnification

The participant recognizes that there is risk involved in the types of activities offered by CrossFit254. Therefore, the participant accepts financial responsibility for any injury that the participant may cause either to him/herself 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 CrossFit254, 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 CrossFit254, at the main building or abroad. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by CrossFit254.

Release

In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willinglyand voluntarily participating in the activities offered by CrossFit254, I, the undersigned hereby release CrossFit254, 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 participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with CrossFit254 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.
Please draw out your signature on the above field to continue.