CrossFit Danbury Liability Waiver (5570)
Waiver and Release of Liability Express assumption of risk: I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; strains and sprains. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner( s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of Underground Athletics LLC. I acknowledge that I have no physical impairments, injuries, or illnesses that will endanger me or others Initials:
Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by Underground Athletics LLC, I, the undersigned hereby release Underground Athletics, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with Underground Athletics LLC to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child. Indemnification: The participant recognizes that there is risk involved in the types of activities offered by Underground Athletics LLC. Therefore the participant accepts financial responsibility for any injury that the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Underground Athletics LLC, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by Underground Athletics LLC at the main building or abroad. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by Underground Athletics LLC. I have read and understood the foregoing assumption of risk. and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent Or intentional act Or omission. I understand that by signing this form I am waiving valuable legal rights.
Photography/ Video Release: Participants involved in any activities offered by Underground Athletics LLC may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the Underground Athletics LLC website or in any editorial, promotional or advertising material produced and/or published by Underground Athletics. Initials:
Auto Debit: will occur every month thereafter, until the client cancels the contract by WRITTEN notice with 30 days notice either mailed to
Underground Athletics LLC, 6 Christopher Columbus Ave Danbury, CT 06810 or by email to email@example.com.
Late Charge: You will be charged $15 for all installments in default if payment is not made within 10 days of due date, unless you
have cancelled your contract based on cancellation policy.
By signing, I acknowledge that I understand how to properly cancel the auto debit. Must give 30 days written notice in order to cancel.
Authorization to Debit Account:
By signing, I authorize Underground Athletics LLC to debit my account according to the terms stated in this agreement.
Please answer the following questions