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Fitness Waiver /Release Of Liability
Waiver and Release Of Liability In consideration for the participation in indoor cycling, personal training, group fitness or similar classes or instruction, in person or online (the "Activity"), and for other good and valuable consideration, the receipt and sufficiency whereof being duly acknowledged, to the fullest extent permitted by law, I hereby release, discharge, hold harmless and covenant not to sue DDB fitness LLC, its affiliates, managers, members, agents, attorneys, staff, volunteers, representatives, predecessors, successors and assigns (each a “Releasee”) from all actions, causes of action, suits, damages, claims and demands whatsoever which against the Releasee, I, my administrators, executors, heirs, beneficiaries, successors and assigns ever had, now have or hereinafter can, shall or may have, for, upon, or by reason of any matter arising out of the Activity including, without limitation, negligent rescue operations; and agree that if I, or anyone on my behalf, makes a claim against any of the Releasees that is prohibited by this instrument, I, my representative or my estate, as the case may be, will indemnify, defend, and hold harmless each of the Releasees from and against any claim, loss, liability, damage, or cost including, without limitation, reasonable attorney’s fees, which any Releasee may incur as the result of such claim. I WARRANT AND REPRESENT THAT I AM IN GOOD HEALTH AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN THE ACTIVITY; THAT IF I BELIEVE OR HAVE KNOWLEDGE THAT THE ACTIVITY WILL BE INJURIOUS TO MY HEALTH OR WELLBEING, I WILL IMMEDIATELY DISCONTINUE PARTICIPATION IN THE ACTIVITY; THAT I FULLY UNDERSTAND THAT PARTICIPATION IN THE ACTIVITY INVOLVES RISKS OF SERIOUS BODILY INJURIES, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH, WHICH MAY BE CAUSED BY MY OWN ACTIONS OR OMISSIONS, OR THE ACTIONS OR OMISSIONS OF OTHERS; AND THAT THERE MAY BE OTHER RISKS EITHER KNOWN TO ME OR NOT READILY FORESEEABLE AT THIS TIME; AND I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, EXPENSES, COSTS AND DAMAGES I INCUR AS A RESULT OF MY PARTICIPATION IN THE ACTIVITY. I HEREBY FURTHER WARRANT AND REPRESENT THAT I HAVE EITHER CONSULTED A PHYSICIAN CONCERNING MY PARTICIPATION IN THE ACTIVITY AND HAVE RECEIVED CLEARANCE FROM SAID PHYSICIAN TO PARTICIPATE IN THE ACTIVITY, OR HAVE WILLINGLY CHOSEN NOT TO CONSULT A PHYSICIAN PRIOR TO MY PARTICIPATION, AND ASSUME THE RISKS ASSOCIATED WITH MY DECISION NOT TO CONSULT A PHYSICIAN. In the event that any provision contained within this Waiver and Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion hereof shall be determined to be unlawful or otherwise unenforceable, the remainder hereof shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. This Waiver and Release of Liability shall be governed and interpreted in accordance with New York law. I consent and agree to the venue of any action or proceeding commenced by or against DDB Fitness LLC arising out of my participation in the Activity being in the Supreme Court of New York, County of New York. I acknowledge that the representations, warranties, covenants and promises contained in this document are material inducements for DDB Fitness LLC to permit me to participate in the Activity.
Emergency Contact
Name
First
Last
Relationship to You
Phone
Relationship to You
Phone
Signature
I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER (OR IF I AM UNDER 18 YEARS OF AGE, MY LEGAL GUARDIAN MUST SIGN THIS ON MY BEHALF) AND THAT I AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS WAIVER AND RELEASE OF LIABILITY CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND THAT I AM SIGNING IT OF MY OWN FREE WILL.
Signature
Name
*
First
Last
Email
*
Date
*
MM slash DD slash YYYY
Please initial here
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Agreement Form
Name
*
First
Last
Email
*
Congratulations on your decision to participate in an exercise program. Together, we will improve your ability to accomplish your training goals faster, safer, and with maximum benefits. In order to maximize progress, it will be necessary for you to follow program guidelines during supervised and (if applicable) unsupervised training days. Remember, exercise and healthy eating are EQUALLY important!
Personal Training Terms and Conditions
• Personal training sessions that are not rescheduled or canceled 24 hours in advance (with emergency exceptions) will result in a session full rate fee.
• Payment is due at the completion of each session (cash, check, Venmo, Zelle, Chase QuickPay)
• Clients arriving late will receive the remaining scheduled session time, unless other arrangements have been previously made with the trainer.
I agree to the terms. Please initial here:
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PAR-Q/ Goal Form
Name
*
First
Last
Your Age
Email
*
Physical Activity Readiness
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
Yes
No
Do you feel pain in your chest when you perform physical activity?
Yes
No
In the past month, have you had chest pain when you were not performing any physical activity?
Yes
No
Do you lose your balance because of dizziness or do you ever lose consciousness?
Yes
No
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Yes
No
Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?
Yes
No
Do you know of any other reason why you should not engage in physical activity?
Yes
No
If you have answered YES to one or more of the above questions, consult your physician before engaging in physical activity. Tell your physician which questions you answered YES to. After medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition.
Occupational
What is your current occupation?
Does your occupation require extended periods of sitting?
Yes
No
Does your occupation require repetitive movements?
Yes
No
Discuss repetitive movements
Does your occupation require you to wear shoes with a heel (e.g., dress shoes)?
Yes
No
Does your occupation cause you mental stress?
Yes
No
Recreational
Do you partake in any recreational physical activities (golf, skiing, etc.)
Yes
No
Please discuss activities:
Do you have any additional hobbies (reading, video games, etc.)?
Yes
No
Please discuss hobbies:
Medical
Have you ever had any injuries or chronic pain?
Yes
No
Discuss injuries or chronic pain
Have you ever had any surgeries?
Yes
No
Discuss surgeries
Has a medical doctor ever diagnosed you with a chronic disease, such as heart disease, hypertension, high cholesterol, or diabetes?
Yes
No
Discuss diagnoses
Are you currently taking any medication?
Yes
No
Please list medications
Goals
Please select all goals below that apply to you
Lose Body Fat
Develop Muscle Tone
Rehabilitate an Injury
Education
Start an Exercise Program
Sports Specific Training
Increase Muscle Size
Fun
Motivation
What is your current fitness routine, if any?
What are your favorite formats of exercise?
What are you least favorite formats of exercise?
Please list in order of priority, the fitness goals you would like to achieve in the next 3-12 months
Outline what you feel are the obstacles or your potential actions, behaviors or activities that could impede your progress towards accomplishing your goals (i.e. not training consistently, upcoming vacation, busy season at work, not following the program, etc.)
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