Gym Waiver Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.I am completing this for: *MyselfA minor that I am a guardian ofPARTICIPANT INFORMATIONParticipant Name *FirstLastParticipant Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Participant Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeParticipant PhoneParticipant Email *Emergency Contact InformationEmergency Contact Name *FirstLastEmergency Contact Relationship *Emergency Contact Phone *HEALTH QUESTIONNAIREHas a physician ever advised you to limit physical activity due to a heart condition? *NoYesDo you experience chest pain during physical activity? *NoYesHave you experienced chest pain within the past month when not exercising? *NoYesDo you lose balance due to dizziness or experience loss of consciousness? *NoYesDo you have any bone, joint, muscle, or medical condition that may be aggravated by exercise? *NoYesAre you currently taking medication that may affect your ability to exercise safely? *NoYesIs there any other reason you should not participate in physical activity? *NoYesBecause you answered "Yes" to one or more questions above, please explain: *ASSUMPTION OF RISKI understand that participation in fitness training, strength and conditioning, group exercise classes, open gym activities, personal training, and use of Freemotion Athletics facilities and equipment involves inherent risks. These risks include, but are not limited to: Muscle strains and sprains Falls and impact injuries Equipment malfunction or misuse Overexertion Heart attack, stroke, or other medical emergencies Serious injury, permanent disability, or death I understand that exercise may push me beyond my physical limits and that I am responsible for monitoring my own condition and immediately notifying staff if I experience discomfort, dizziness, pain, unusual fatigue, or other symptoms. I knowingly and voluntarily assume all risks associated with participation in activities at Freemotion Athletics. ASSUMPTION OF RISK *24-HOUR ACCESS ACKNOWLEDGMENTI understand that portions of Freemotion Athletics may be accessible without staff supervision. I acknowledge that: I may exercise alone without immediate assistance available. I am solely responsible for my safety while using the facility during unstaffed hours. I should seek medical clearance before beginning any exercise program if I have health concerns. My access privileges may be suspended or revoked for violations of gym rules or misuse of facilities. 24-HOUR ACCESS ACKNOWLEDGMENT *RELEASE OF LIABILITYIn consideration for being allowed to participate in activities and use facilities operated by Freemotion Athletics, I hereby release, waive, discharge, and hold harmless Freemotion Athletics, its owners, employees, contractors, coaches, volunteers, agents, and representatives from any and all claims, liabilities, demands, actions, damages, costs, or expenses arising from or related to my participation, including claims arising from ordinary negligence. This release applies to any injury, illness, disability, property damage, or death resulting from participation in activities or use of equipment and facilities. If any provision of this waiver is found unenforceable, the remaining provisions shall remain in full force and effect. RELEASE OF LIABILITY *INDEMNIFICATIONI agree to indemnify and hold harmless Freemotion Athletics, its owners, employees, contractors, coaches, volunteers, and agents from any claims, damages, liabilities, costs, or attorney's fees arising from my actions, negligence, or misconduct while participating in activities or using the facilities. INDEMNIFICATION *MEDICAL CONSENTIn the event of injury, illness, or emergency, I authorize Freemotion Athletics staff or representatives to obtain emergency medical treatment on my behalf if I am unable to do so. I understand that I am solely responsible for all medical expenses incurred. MEDICAL CONSENT *PERSONAL PROPERTYI understand that I am responsible for my personal belongings. Freemotion Athletics is not responsible for lost, stolen, or damaged property. PERSONAL PROPERTY *PHOTO & VIDEO RELEASEI grant Freemotion Athletics permission to photograph, video record, and use my likeness in promotional, marketing, educational, and social media materials without compensation. I understand that these images may be edited, published, and distributed in print or digital formats. PHOTO & VIDEO RELEASE *I AgreeI Do Not AgreeParticipant Signature * Clear Signature Printed Name *Date *Parent/Guardian Name (FOR PARTICIPANTS UNDER 18) *Parent/Guardian Signature (FOR PARTICIPANTS UNDER 18) * Clear Signature Parent/Guardian Date (FOR PARTICIPANTS UNDER 18) *Submit Waiver