Waiver for Fitness Services

Progress:

What is the name of the party that is providing the service or activity to which this waiver relates? This party will be called the "provider" moving forward. Enter the full legal name of the party, including any suffixes (such as "Pty Ltd" if the party is a company). Do not include an ACN or ABN, as they can be entered in the next few questions.

Enter the full legal name of the party that is providing the service or activity to which this waiver relates. For example, if this waiver is being used for a gym, enter the name of the owner of the gym. The party named here will be called the "provider" in future steps. Enter the full legal name of the provider, including any suffixes (such as "Pty Ltd" if the provider is a company). Do not include an Australian Company Number (ACN) or an Australian Business Number (ABN), as they can be entered in the next few questions.

Need
help?

Customise the template

Preview your document

**********

** IMPORTANT **

MESSAGE TO THE DOCUMENT CREATOR:

This document deals with a complicated area of law and serious legal risks.

It is possible that this document will not adequately address your circumstances.

This document is provided as a guide only and should always be reviewed by a lawyer before use.

This page may be removed before using this document with customers or participants.

**********

WAIVER, RELEASE, RISK WARNING, AND ACKNOWLEDGEMENT OF RISK

________ (hereinafter "Provider")
of ________

PARTICIPANT DETAILS (hereinafter "Participant"):

Participant Name: ________
Participant Address:

________

Emergency Contact: ________

THIS WAIVER (hereinafter "Waiver") relates to the Participant's participation in the following activity (hereinafter "Fitness Activity"): ________

The Fitness Activity is provided by the Provider.

IN CONSIDERATION for the Provider allowing the Participant to take part in the Fitness Activity, the Participant and the Guardian agree to the terms set out in this Waiver.

(1) Participant's Health and Pre-existing Conditions.

Place an "X" or a check mark next to the statements that are true:

................... I wear a pacemaker.

................... I wear contact lenses.

................... I wear a hearing aid.

................... I wear dentures.

If you experience pain or discomfort in any part of your body, please describe this pain or discomfort, including the location on the body and the cause, if known:

.......................................................................................................................................
.......................................................................................................................................
.......................................................................................................................................
.......................................................................................................................................

Describe your stress level:

List all injuries you have experienced in the past two years:

List any health disorders you have or any areas which may be sensitive to physical touch:

List all medications you are taking:

List any other information related to your health that may be important for the Provider to be aware of:

(2) Please carefully review each section below. By initialing each section, you confirm that you understand and agree to the relevant section:

................... The Fitness Activity may involve a number of exercises or activities including but not limited to: ________

................... Participation in the Fitness Activity involves risks which may include but are not limited to death, personal injury and damage to property. It may also involve specific risks including but not limited to: Head injuries, spinal damage, bone fractures, sprains, strains, muscle tears, ligament damage, bruises, abrasions, open wounds, dislocations, dehydration, heat stress, heart attack, stroke, cardiovascular complications, infection, disease, or any other injuries or illnesses related to overuse, exertion or exposure.

................... I warrant and represent that I understand the nature of the Fitness Activity and the risks involved with it.

................... I acknowledge and understand that I am choosing voluntarily to take part in the Fitness Activity and that I am free to refuse to participate in it at any time.

................... I warrant and represent that I am in good health and physical condition.

................... I warrant and represent that I do not suffer from any health condition which may affect my ability to safely participate in the Fitness Activity.

................... I acknowledge and agree that if I have any concerns or reservations about my health or my ability to participate safely in the Fitness Activity, I must take advice from a medical professional before taking part in the Fitness Activity.

................... I warrant and represent that if at any time I believe that the conditions of the Fitness Activity are unsafe for me (taking into account my own health and physical circumstances), I will immediately stop taking part in the Fitness Activity.

................... I understand that if I feel faint, dizzy, nauseous, or lightheaded, or experience chest pain or any other pain or discomfort, I must stop the Fitness Activity immediately and notify the Provider or a member of the Provider's staff.

................... I understand that the Fitness Activity is a supportive environment where health and well being are of paramount importance. We all progress at different rates and there is no shame in slowing down or taking a break.

................... I agree that I know my own body better than anyone else does and it is ultimately up to me to decide if the conditions of the Fitness Activity are unsafe for me, and to speak up if I have concerns.

................... I agree that I will comply with the Provider's rules and any directions given to me by the Provider or the Provider's staff members.

................... I warrant that I will compensate the Provider for any damage which I may cause to the Provider's equipment as a result of my recklessness or negligence.

................... I acknowledge that the Provider is not responsible for the safety or security of my personal belongings while I am taking part in the Fitness Activity. In the event that the Provider offers lockers or any other place to leave my personal belongings, I use these at my own risk.

................... I, on behalf of myself, my heirs, assigns, administrators, executors and next of kin hereby irrevocably and unconditionally waive any and all claims, expenses, causes of action, debts, demands, damages, or other liabilities whatsoever (hereinafter "Liabilities"), whether direct or indirect, and whether known or unknown that I may have now or in the future against the Provider, together with any coaches, trainers, teachers, instructors, officers, employees, directors, trustees, agents, contractors, assignees, successors or other representatives of the Provider (hereinafter "Provider's Representatives"). I hereby release the Provider and the Provider's Representatives from any such Liabilities which I may have or may at any time incur against the Provider or any of the Provider's Representatives, whether direct or indirect, and whether known or unknown, and whether in contract, tort, equity or otherwise, except Liabilities arising out of gross negligence by the Provider or the Provider's Representatives.

................... 5, 22 825582 22 228282, 22 52858, 5888228, 55282882552258, 252852258 525 2252 22 282 525282 85528285882 525 528225828225882, 5282582, 588855522, 825222822, 525 2222 82522282825, 252 25288525, 22222525 8825 522 22 252 25288525'8 822528222528828, 2522 522 525 588 28588882828, 8522525 585282 25 82585282, 525 8522525 22282 25 5222282, 85885 252 25288525 25 252 25288525'8 822528222528828 252 82855 228 25 82 252 252552 82 8222282822 8825 22 2552888252822 82 252 2822288 88288822.

................... I authorise the Provider and the Provider's staff to provide first aid, to seek emergency medical support and/or to transport me to a medical facility in the event that I suffer an injury or medical emergency at any time. I acknowledge and accept that I will be responsible for any medical expenses that are incurred.

................... I authorise the Provider and the Provider's staff to take photographs or videos of me while participating in the Fitness Activity and to use such photographs or videos for promotional purposes including use on social media or other websites. I understand that if I do not want photographs or videos of me to be used by the Provider for promotional purposes, then I must notify the Provider of this in writing.

Financial Notice: In the event that you wish to cancel an appointment, you are required to give at least the following amount of notice: ________

If this notice is not received, the following will apply:

________

Late Arrivals: 52 225 555882 8522 22 2255 52228222222, 225 5882 558822 2255 2822 852522225 22 58822225522 588 885255825 8882228. 2522 225 555882, 252 25288525 8888 588252582 8522525 5 8522 82552 88 22888882. 8 8522 82552 252 222 82 22888882 82 225 5582 5558825 222 8522 25 82 252 25288525 28258 522 525822 22 852828 252 52228222222. 8225558288 22 252 2528222 25 2822, 225 8888 82 52822288882 225 252 2588 8282 22 252 8288822. 552522252, 282582 52 222 555882 8522.

Applicable Law: This Waiver shall be governed in all respects by the laws of New South Wales and any applicable federal law.

I have read and understood this Waiver in its entirety. I acknowledge that by signing this Waiver I am giving up certain legal rights which I may have against the Provider, including the right to sue. I am assuming all risk and taking full responsibility for any personal injuries, death, loss or damage to property, liabilities or other losses which I might incur in relation to the Fitness Activity, and I am engaging in the Fitness Activity at my own risk.

Signed by the Participant:

..............................................
________

..............................................
Date

Witnessed by:

..............................................
Witness signature

..............................................
Witness name (print)