Registration of interest - Baby & Me ClassPlease complete the form below to register your interest in our Baby & Me class - we’ll keep you updated with all the information! Name * First Name Last Name Phone (###) ### #### Email * Date of birth MM DD YYYY Emergency Contact First Name Last Name Phone * (###) ### #### Relationship How old is your child? What classes would you be interested in attending: Tuesday 9.30am Thursday 9.30am Both If the above times don't suit you - let us know below what would be suit your schedule: What is your level of experience in a gym setting? Please provide details below Have you had clearance from your GP or Women’s health physio to commence excercise postpartum? Yes No N/A Additional comments if required: Do you have any health conditions, pre or exsisting injuries or conditions that would affect your ability to complete physical exercise? Yes No If yes, please provide details below 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 Thank you!
