INFORMED CONSENT/ASSUMPTION OF RISK
I agree to participate in one or more physical fitness
program(s)/class(es) sponsored by Mako Athletics, which may include, but not
necessarily be limited to CrossFit Training, and/or training of any kind by any
affiliate, subsidiary or partnership of Mako Athletics has made me fully aware
that the fitness programs/classes which Mako Athletics offers and in which
I desire to participate are of a nature and kind that are extremely strenuous
and can/may push me to the limits of my physical abilities. I the undersigned
recognize and understand that the programs/classes are not without varying
degrees of risk which may include, but are not limited to the following: injury
to the musculoskeletal and/or cardio respiratory systems 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, rhabdomyolysis, or injury or death due to
a medical condition, whether known or unknown by me. 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 any and all risks
that I am exposing myself to as a result of my participation in Mako Athletics
programs/classes and accept full responsibility for any injury or death that
may result from participation in any activity, class or physical fitness
program. I herby certify that I know of no medical problems that would increase
my risk of illness and injury as a result of participation in a weightlifting
competition ran by Mako Athletics. I have been informed that there exists
the possibility of adverse physical changes during an exercise program, and I
fully understand the same. Mako Athletics informed me that these changes could
include abnormal blood pressure, fainting, disorder of heart rhythm, stroke,
and in very rare instances, heart attack or even death, and I fully understand
the same. With my full understanding of the above information, I agree to
assume any and all risk associated with my participation in Mako Athletics
fitness programs.
Release:
In full consideration of the above mentioned risks and hazards
and in full consideration of the fact that I am willingly and voluntarily
participating in the activities made available by Mako Athletics, and with my
full understanding of all of the above, I hereby waive, release, remise and
discharge Mako Athletics and its agents, officers, principals and employees and
volunteers, of any and all liability, claims, demands, actions or rights of
action, or damages of any kind related to, arising from, or in any way
connected with, my participation in Mako Athletics fitness
programs/classes/boot camps, 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 Mako Athletics 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.
Use of picture(s)/film/likeness: I agree to allow Mako
Athletics, its agents, officers, principals, employees and volunteers to take
and use picture(s), film and/or likeness of me for advertising purposes. In the
event I choose not to allow the use of the same for said purpose, I agree that
I must inform Mako Athletics of this in writing.
I have fully read and fully understand 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.