Waiver | CrossFit Max Level

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Physical Activity Readiness Questionnaire

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

YesNo

Do you feel pain in your chest when you do physical activity?

YesNo

In the past month, have you had chest pain when you were not doing physical activity?

YesNo

Do you lose balance because of dizziness or do you ever lose consciousness?

YesNo

Do you have bone or joint problem (for example, back, knee, or hip) that could be worsen by a change in your physical activity?

YesNo

Is your doctor currently prescribing drugs (for example water pills) for your blood pressure or heart condition?

YesNo

Do you know of any other reason why you should not do physical activity?

YesNo

Informed Consent

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 uring, and pain in the kidney areas in the days following a particulary 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 CrossFit Max Level 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).

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ParQ & Informed Consent/Waiver

Section 1

I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in CrossFit Max Level 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 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 CrossFit Max Level. With my full understanding of the above information, I agree to assume any and all risks associated with my participation in CrossFit Max Level programs/classes.

Initials here*

Section 2

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 CrossFit Max Level, 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.

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Waiver & Release

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 CrossFit Max Level (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 CrossFit Max Level activities, including, but not limited to the personal training / nutritional programs and programs/classes.

Initials here*

Photo & Video Release

I hereby grant CrossFit Max Level permission to use my photograph/video image in any and all publications for CrossFit Max Level, including web site entries, without payment or any other consideration in perpetuity. I hereby authorize CrossFit Max Level to edit, alter, copy, exhibit, publish or distribute 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 CrossFit Max Level 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 this authorization.

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Indemnification

I recognize that there is risk involved in the types of activities offered by CrossFit Max Level. 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 CrossFit Max Level, 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 Max Level.

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CrossFit Max Level strives to provide a positive and encouraging environment for our clients. Anyone that is disruptive or negatively influences this environment is subject to having their membership revoked. This is at the sole discretion of managment *

Initials here*

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 at CrossFit Max Level.

Initials here*

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.

Initials here*

ParQ & Informed Consent/Waiver

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by
the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

CrossFit Max Level has put in place preventative measures to reduce the spread of COVID-19; however, CrossFit Max Level cannot guarantee that you will not become infected with COVID-19. Further, attending CrossFit Max Level could increase your risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19
and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending CrossFit Max Level and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at CrossFit Max Level may result from the actions, omissions, or negligence of myself and others, including, but not limited to, CrossFit Max Level employees, other members and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole
responsibility for any injury to myself (including, but not limited to,
personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my
attendance at CrossFit Max Level. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless CrossFit Max Level, its employees, and it's members, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating there to.

I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of CrossFit Max Level, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any CrossFit Max Level program.

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