Freemotion Athletics

Gym Waiver

I am completing this for:

PARTICIPANT INFORMATION

Participant Name
Participant Date of Birth
Participant Address

Emergency Contact Information

Emergency Contact Name

HEALTH QUESTIONNAIRE

Has a physician ever advised you to limit physical activity due to a heart condition?
Do you experience chest pain during physical activity?
Have you experienced chest pain within the past month when not exercising?
Do you lose balance due to dizziness or experience loss of consciousness?
Do you have any bone, joint, muscle, or medical condition that may be aggravated by exercise?
Are you currently taking medication that may affect your ability to exercise safely?
Is there any other reason you should not participate in physical activity?

ASSUMPTION OF RISK

I 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.

24-HOUR ACCESS ACKNOWLEDGMENT

I 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.

RELEASE OF LIABILITY

In 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.

INDEMNIFICATION

I 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.

MEDICAL CONSENT

In 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.

PERSONAL PROPERTY

I understand that I am responsible for my personal belongings. Freemotion Athletics is not responsible for lost, stolen, or damaged property.

PHOTO & VIDEO RELEASE

I 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
Clear Signature