Name *

First Name

Last Name

Phone

(###)

###

####

Date of birth

MM

DD

YYYY

Name of Friend at Unit 54

First Name

Last Name

Emergency Contact

First Name

Last Name

Phone *

(###)

###

####

Do you have any health conditions, pre or exsisting injuries or conditions that would affect your ability to complete physical exercise?

Yes

No

Waiver

CrossFit Waiver and Release of Liability I, hereby acknowledge and agree to the following terms and conditions as a prerequisite for participating in any activities, programs, or events offered by Unit 54 - Upper Hutt CrossFit: 1. Assumption of Risk: I understand and acknowledge that participating in CrossFit activities involves inherent risks, including but not limited to, physical exertion, strenuous exercise, potential bodily injury, and the risk of contracting illnesses. I voluntarily assume all risks associated with my participation in CrossFit activities and hold Unit 54 – Upper Hutt CrossFit, its owners, employees, instructors, and agents harmless from any and all claims, actions, suits, or demands arising from such risks. 2. Health and Medical Condition: I confirm that I am physically fit and have no medical conditions or limitations that would prevent me from safely participating in CrossFit activities. I understand that it is my responsibility to consult with a healthcare professional and obtain medical clearance if necessary, before commencing any exercise program. I further acknowledge that Unit 54 – Upper Hutt CrossFit is not responsible for assessing my physical condition or medical suitability for participation. 3. Waiver and Release of Liability: In consideration for being permitted to participate in CrossFit activities, I hereby waive, release, and discharge Unit 54 – Upper Hutt CrossFit its owners, employees, instructors, and agents from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or illness that may occur as a result of my participation in CrossFit activities, including but not limited to, negligence, gross negligence, or any other act or omission of Unit 54 – Upper Hutt CrossFit or its representatives. 4. Indemnification: I agree to indemnify and hold harmless Unit 54 – Upper Hutt CrossFit its owners, employees, instructors, and agents from any and all claims, actions, suits, or demands, including attorney fees and expenses, arising from my participation in CrossFit activities or my breach of any terms outlined in this waiver. 5. Photographic and Video Release: I grant Unit 54 – Upper Hutt CrossFit the permission to use my likeness in photographs, videos, or other media for promotional or educational purposes without compensation or further notice. I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY CAREFULLY AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT BY SIGNING THIS DOCUMENT, I AM WAIVING CERTAIN LEGAL RIGHTS AND ACKNOWLEDGING THE ASSUMPTION OF RISK INVOLVED IN PARTICIPATING IN CROSSFIT ACTIVITIES.

I agree

I disagree