Muskegon CrossFit Informed Consent / Assumption of Risk:
I, ________________________, am aware that there are significant risks involved in all aspects of physical training. I understand that
the reaction of the heart, lungs and vascular system to exercise cannot always be predicted with accuracy. I understand that there is a
risk of certain abnormal changes occurring during or following exercise which may include abnormalities of blood pressure or heart rate;
chest, arm or leg discomfort; transient light-headedness or fainting; and in rare instances, heart attack, stroke or even death. Excessive
work can result (in rare cases) in exertional rhabdomyolosis. I should look for signs of excessive soreness, darkened urine, and pain in
the kidney areas in the days following a particularly intense workout. While this type of injury is relatively rare, it can occur due to a
number of factors, including (but not limited to) genetic predisposition or dehydration, that may be beyond the control of my trainer. I
understand that the programs and classes offered by Muskegon CrossFit are of a nature and kind that are extremely strenuous and
can/may push me to the limits of my physical abilities. 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. 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 Muskegon
CrossFit programs/classes/events and accept full responsibility for any injury or death that may result from participation in any activity,
class or physical fitness program. I hereby certify that I know of no medical problems that would increase my risk of illness and injury
as a result of participation in a fitness program designed by Muskegon CrossFit. With my full understanding of the above information, I
agree to assume any and all risk associated with my participation in Muskegon CrossFit programs/classes/events.
By signing this document, I acknowledge that I have voluntarily chosen to participate in a program of progressive, physical exercise. By
signing this document, I acknowledge being informed of the strenuous nature of the program and the potential for unusual, but possible,
physiological results including, but not limited to, abnormal blood pressure, rhabdomyolosis, fainting, heart attack, or death. By signing
this document, I assume all risk for my health and well-being and hold Muskegon CrossFit, as well as its owners, employees, and other
authorized agents including independent contractors, harmless there from. I understand that questions about exercise procedure and
recommendations are encouraged and welcome.
Waiver and Release: X.________
I fully understand that my personal exercise program may be strenuous and I choose to participate voluntarily. I accept all responsibility
for my health and any results, injury or mishaps that may affect my well-being or health in any way. I waive any claims, demands,
causes of action or any claims for relief whatsoever against, and release Muskegon CrossFit (as well as any of its owners, employees,
or other authorized agents, including independent contractors) from any and all liability, claims and/or causes of action that I may have
for injuries or other damages, arising out of participation in Muskegon CrossFit activities, including, but not limited to the personal
training / nutritional programs and programs/classes.
Photo/Video Release: X.________
I hereby grant Muskegon CrossFit permission to use my photograph/video image in any and all publications for CrossFit or Muskegon
CrossFit, including website entries, without payment or any other consideration in perpetuity. I hereby authorize Muskegon CrossFit to
record, edit, alter, copy, exhibit, publish or distribute collectively, “Use” all photos and images. I waive the right to inspect or approve the
finished product, including written or electronic copy, wherein my photo appears. Additionally, I waive any right to royalties or other
compensation arising or related to the use of the photograph or video images. I hereby hold harmless and release and forever
discharge Muskegon CrossFit from all claims, demands, and causes of action which I, my heirs, representatives, executors,
administrators, or any other persons acting on my behalf of on behalf of my estate which may have or may have by reason of such Use
or this authorization.
Indemnification : X.________
I recognize that there is risk involved in the types of activities offered by Muskegon CrossFit. Therefore I accept financial responsibility
for any injury that I may cause either to myself 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 Muskegon CrossFit, 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 Muskegon CrossFit.
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
I have carefully read this Agreement and fully understand its contents. I am aware that this is a release and waiver of liability and sign it
knowingly, voluntarily, and of my own free will.
Participant’s Signature Participant’s Name (printed) Date
If the participant is under the age of 18,
Parent/guardian Signature Parent/guardian name (printed) Date