Waiver | Corespeed Gym

Corespeed Gym Waiver of Liability

Participant Name

Date of Birth

Address/City

Parent/Guardian Name

Cell Phone & Email

> ADULT participants (18 yrs & Older) who are financially responsible for their training, type N/A in this section.

Are there any medical concerns within the past 5 years we should be aware of?

Have you been released by a physican to participate in physical activity

Yes

N/A

I declare that the information I’ve provided above is accurate & complete

I hereby agree to inform instructors and CoreSpeed Gym of any medical concerns. I understand that photos/videos may be taken during this activity and may be used for promotional material for CoreSpeed Gym's programs and you hereby agree to such use. I hereby acknowledge that the use of the services, equipment or premises of CoreSpeed Gym involves risks of injury to persons and property, including but not limited to injuries arising from use of exercise equipment and machines; injures arising from participation in supervised or unsupervised activities or programs at CoreSpeed Gym; injuries and medical disorders arising from exercising at CoreSpeed Gym, such as heat stress, sprains, broken bones, and torn muscles and ligaments, among others; and accidental injuries occurring anywhere at CoreSpeed Gym. You hereby assume full responsibility for you or your child’s participation.

Parent/Guardian Signature (Must be 18yrs or older)

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Your Speed & Strength Training Headquarters

YEAR ROUND

Since 2004

Corespeed Gym Waiver of Liability

> ADULT participants (18 yrs & Older) who are financially responsible for their training, type N/A in this section.