ALPHA BARBELL CLUB WAIVER: 10512 DIXIE HWY, LOUISVILLE, KY 40272. 502.526.6169 mkmilburn89@gmail.com
I, {name}, hereby agree that by signing this document, I consent to waive certain legal rights, including the right to sue the following party, and, if applicable, it’s owners, trainers, representatives, and facilities from any physical, material, tangible or intangible, loss or damages that may happen to me during my participation in any of the fitness services (hereinafter, “Fitness Services”) undertaken while under their instruction or thereafter: ALPHA BARBELL (the “Fitness Provider”). I will voluntarily participate in the Fitness Services that will be conducted by the Fitness Provider; These Fitness Services will include, but are not limited to the following: strength training, cardio equipment, heavy bag, speed bag, free weights, and machines.
CONTACT INFORMATION:
Client Name: {name} Client date of birth: {dob} Phone# {phone}
Client Address: {address}
Client Email:
Emergency Contact/Number: {contact_name}. {contact_phone}
My initials below indicate that I agree with and understand the following:
It is my responsibility to consult a physician before participating in this or any fitness program and I affirm that I have no medical conditions that would restrict me from participating in any fitness services.
I agree to hold the Fitness Provider, and if applicable, it’s owners, trainers, and representatives, harmless from any damage, whether tangible or intangible, that may happen to me while participating in the Fitness Services. Injuries may include, but are not limited to, muscle sprains, muscle spasms, heart attacks, raised blood pressure, and broken, fractured, or dislocated bones.
I agree that the Fitness Provider offers the fitness Services with no guarantee of results. I agree that I am solely responsible for maintaining the diet and fitness regime appropriate for my level of health and stamina, and agree that any results that occur, whether positive or negative, are the effects of my own personal choices.
I agree that participation in the Fitness Services is not a replacement for actual medical care, and that if I do experience medical issues, I will contact my doctor immediately.
I agree and verify that all the information that I have given the Fitness Provider, and its representatives is accurate, up-to-date, and without the omission of any unknown medical issues. I agree and verify that if I have omitted any necessary personal information, whether knowingly or unknowingly, I will hold the Fitness Provider harmless against all liability for any damage that may occur to myself or to others because of my actions or inactions.
I agree to keep the Fitness Provider apprised of any changes or upcoming changes concerning my physical health and personal information.
I understand and agree that it is my responsibility to let the Fitness Provider know if I find myself in any pain or discomfort before, after, or during the Fitness Services.
If I do require medical treatment or attention while or after participating in the fitness Services, I agree that the medical costs are mine and mine alone and hold the Fitness Provider blameless from any charges, fees, or cost that my conditions may incur.
I agree that I will not bring guests into the Fitness Provider’s establishment unless I notify the Fitness Services Provider prior to arrival and agree to take responsibility for all contents of the Fitness Services Waiver for all guests of client. I agree that I will not distribute my code to any other person. I agree that I must take responsibility to ensure that my guest completes the Fitness Service Waiver, pays the $5.00 guest pass fee, and ensures the guest is over or equal to 18 yrs of age prior to use of the Fitness Providers establishment or equipment.
I agree that the Fitness Provider will be notified if a guest is under the age of 18 yrs and a parent or guardian must agree to the terms of the Fitness Provider’s waiver and will sign the waiver the guest.
I agree to not bring any alcohol into the Fitness Providers establishment and agree to rack weights, clean up area after use of the equipment and Fitness Providers establishment.
CLIENTS NAME (PRINT): {name}
PARENT/GUARDIAN NAME (PRINT){contact_name}
DATE: {sign_date}
This Fitness Service Waiver will bind and be enforceable against me and all my personal representatives. I agree that This Fitness Services Waiver should be fully enforceable of the law, and if any portion is held invalid, the remainder should continue in full legal force and effect.
I specifically acknowledge and agree that this document is not intended to be a general release, which would be limited under some state and local laws.
This Fitness Services Waiver shall be construed and interpreted as broadly as possible in the applicable jurisdiction.
ASSUMPTION OF RISK: I understand and am aware that my participation in the Fitness Services involves risks. These risks may lead to tangible or intangible harm, and I agree that they may result not only from my own actions but also from the actions of others. With the knowledge and understanding of these risks, I choose, of my own will and volition, to participate in the Fitness Services. I am also aware that there are risks that I may not have considered, yet I waive my right to any claims that may occur from these unconsidered risks, and I choose, of my own will and volition, to participate in the Fitness Services.
COVENANT NOT TO SUE: I will not start any lawsuit or other court action against the Fitness Provider, nor will I join any such proceeding, including any claim for money damages. I acknowledge and agree that I am entering a covenant not to sue the Fitness Provider in any capacity, including to hold the Fitness Provider liable for any injury, loss, or damage sustained by me or my property, even if it is due to the Fitness Provider’s negligence or omission. I also waive the right of any of my insurers to make any such claim.
INDEMNIFICATIONS: I agree to defend and indemnify the Fitness Provider and any of its affiliates (if applicable) and hold them harmless against all legal claims and demands, including reasonable attorney’s fees, which may arise from or relate to my use or misuse of the Fitness Services or my conduct or actions. I agree that the Fitness Provider shall be able to select its own legal counsel and may participate in its own defense, if desired.
REPRESENTATION: I am over 18 (eighteen) years of age, and am medically and physically able to participate in the Fitness Services.
GOVERING LAW: This Fitness Services Waiver shall be governed by and construed in accordance with the internal laws of Kentucky without giving effect to any choice or conflict of law provision or rule. Each party irrevocable submits to the exclusive jurisdiction and venue of the federal and state courts located in the following county, any legal suit, action, or proceeding arising out of or based upon this Fitness Services Waiver: JEFFERSON COUNTY.
I have read the above Fitness Services Waiver fully and I understand and agree with its contents. I understand and agree that by signing this Fitness Services Waiver I forfeit any right, claim, or ability to hold the Fitness Provider responsible for any tangible or intangible damages, loss of property, or loss of life that may occur during or after my use of the facilities and participation in the Fitness Services.
Membership agreement:
Initial and sign:
I agree that when I become a member of the Fitness Services Provider (Alpha Barbell Club LLC), I agree to pay the monthly dues each month on a reoccurring basis until I or the Fitness Services Provider decides to cancel the membership. I agree to notify the Fitness Services Provider of a 30-day notice to cancel my membership.
CLIENT NAME (PRINT): {name}
DATE: {sign_date}
PARENT/GUARDIAN NAME (PRINT): {contact_name}
