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Name:________________________________________________________________
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THEFOLLOWINGISAWAIVERREADITBEFORESIGNING
BYAFFIXINGMYSIGNATURETOTHISDOCUMENT,IATTEST,CONTRACT,
UNDERSTANDANDAGREETHATIAMTOBELEGALLYBOUNDBYITSCONTENTS.
Iherebystipulateandagree:
ThatIrealizetherisksofcardiovascularexercise,weighttrainingand/orbodybuilding,and
Iamfullyawareofthepossibilityofmechanicaland/orothermalfunctionsofcardiovascular
equipment,weightmachines,and/orweightmachinesandapparatus,[equipment]dueto
thenegligenceofSummitFitnessandWellnessorotherwise,aswellasthepossibilityof
injurytomypersonasa,resultoftheuseofsuchcardiovascularequipment,weight
machines,and/orweightmachinesandapparatus.I,thereforefullyunderstandandIam
mindfuloftheseriousconsequenceswhichmightresultduetomyinvolvementin
cardiovascularexercise,weightlifting,weighttrainingand/orbodybuildingwhileatSummit
FitnessandWellness.Premises,andbasedonthatunderstanding,assetforthinthis
paragraph,Ivoluntarilyassumeanyandallriskofloss,damageorinjuryofanykind
whatsoeverfrommyuseofanyandalloftheequipmentandfacilitiesatSummitFitness
andWellness,andfurtherandwithfullknowledgeoftheconsequences(i.e.thatIam
waivingmyrighttosue)expresslywaiveanyandallliabilityonthepartofSummitFitness
andWellness.
ThatIamphysicallysoundandhavemedicalapprovaltoproceedwithanormalroutineof
exercise.Thatallexercisesshallbeundertakenbymeatmysolerisk.ThatIamingood
healthandhavenophysicalconditionsthatwouldbeaggravatedbymyinvolvementin
cardiovascularexercise,weightlifting,weighttrainingand/orbodybuilding,nordoIhave
anyphysicallimitations
thatwouldprecludesaidinvolvement.IalsoreleaseSummitFitnessandWellnessandits
contractors(thepersonaltrainers)fromliabilityfortheirnegligence,defectiveequipment,
injuriesfromdangerousconditionsofproperty,etc.
ThatIamforewarnedthatSummitFitnessandWellnesswillnotinanyeventprovide
medicaland/orhospitalizationinsuranceformybenefit,andintheeventofaninjurytomy
personoccurringeitherasaresultofmybeingonanyportionofthepremisesofSummit
FitnessandWellness.IwillsaveharmlessandkeepindemnifiedAdvantagePersonal
TrainingCenter
andtheirrespectivetrustees,beneficiaries,staff,andofficersfromandagainstanyandall
actionclaims,costs,expensesordemands,inrespectofsuchinjuryorinjuries,including
death,howsoevercaused,arisingoutoforinconnectionwithmyuseoftheSummit
FitnessAndWellnessfacilitiesormybeingonanyportionofsaidpremisesand
notwithstandingthatthesamemayhavebeencontributedtooroccasionedbythe
negligenceofSummitFitnessandWellness
ThatIamherebyinformedofmyoptiontosignanewreleaseoneachdatethatIusethe
SummitFitnessandWellnessfacilities.However,IelecttoforegothatoptionandI
thereforeacknowledgeandspecificallyintendthatthisreleaseandwaiverofrightsshallbe
effectivenotonlyonthedatehereof,butalsoonalloccasionssubsequentheretowhenI
shallusetheSummitFitnessandWellnessfacilities.
HAVINGREADTHEABOVETERMSANDINTENDINGTOBELEGALLYBOUND
HEREBYANDUNDERSTANDINGTHISDOCUMENTTOBEACOMPLETEWAIVER
ANDDISCLAIMERINFAVOROFSUMMITFITNESSANDWELLNESSOFANYAND
ALLLIABILITY,IHEREBYAFFIXMYSIGNATUREHERETO.
ClientSignature:______________________________
SignatureofParentorGuardian(ifunder18)_________________________________
Date:____________