Before participating in any activity at CrossFit Gainsborough you must complete this waiver for legal reasons. These forms will be kept in a secure folder only accessible by the CrossFit Gym owner. Thank you!

CrossFit Waiver

Please fill out the following form
in order to participate in our CrossFit Gym.

First Name

Last Name

Date of Birth

Phone

Select an Address

In an emergency I would like CrossFit Gainsborough to contact

Do you smoke?

Yes

Do you drink alcohol?

Yes

Do you take prescription meds?

Yes

Are you exercising now?

Yes

How many times per week?

4-5

2-4

1-2

Do you play sports?

Yes

Do you have back/knee/shoulder pain?

Yes

Do you have previous injuries or surgeries?

Yes

Do you have high blood pressure, asthma, diabetes or a heart condition?

Yes

Do you have any other health conditions not listed?

Yes

If you answered yes to any question, please elaborate

Participants involved in any activities offered by CrossFit Gains may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the CrossFit Gains website, social media or any promotional material produced.

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 CrossFit Gains.

I acknowledge that I have no physical impairments, injuries or illnesses that will endanger me or others.

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 CrossFit Gains, I, the undersigned hereby release CrossFit Gains, 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.

Indemnification: The participant recognises that there is risk involved in the types of activities offered by CrossFit Gains. 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 legal 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 CrossFit Gains, 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 CrossFit Gains, at the main building or elsewhere. This includes, but is not limited to, recreational areas, areas adjacent to main building and/or any areas selected for training by CrossFit Gains.

I have read and understood the foregoing assumption of risk and release of liability and I understand that by signing it obligate 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.

I declare that the info I’ve provided is accurate & complete

Your Signature

Select a date

Thanks for submitting!