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Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
|
Date of Birth
|
Address
|
City
|
State
|
Zip
|
Telephone Number
|
|
Release and Consent for Minor Client
Waiver, Release, and Assumption of Risk Form
This form is an essential legal document. It explains the risks you are assuming by beginning an unsupervised exercise program. You must read and understand it completely. After doing so, please print your name legibly and sign in the spaces provided at the bottom. This is a waiver, informed consent, and covenants not to sue.
Your child or minor must be at least 14 Years old to train at The 12 Training & Wellness, Inc. and its locations. In addition, if your child is 14 to 17, you must accompany your minor at all times in any of our locations.
I am volunteering to participate in a physical exercise program under the direction of The 12 Irv, Inc. and The 12 CM, Inc. & The 12 Training & Wellness, Inc., referred to as The 12, will include, but may not be limited to nutrition, weight, and resistance training. In consideration of The 12 Training & Wellness, Inc. agreements to instruct, assist, and train me, I do at this moment forever release, discharge, and hold harmless The 12 Training & Wellness, Inc. and their respective agents, heirs, assigns, contractors, and employees from any claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting from there.
THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES THAT MAY OCCUR BECAUSE OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK, (2) ANY SLIP, FALL, OR DROPPING OF EQUIPMENT, AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of specific unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in a heartbeat, heart attack, and, in rare instances, death.
I understand that because I participated in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or disabled and incapable of possible gainful employment or having an everyday social life. I recognize that all participants should obtain an examination by a physician before involvement in any exercise program, and I now agree to such before I participate in the program.
I have not obtained a physician’s permission before beginning this exercise program. The 12 Training & Wellness, Inc. agree that I voluntarily and knowingly do so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with all activities and exercises I participate in.
I acknowledge and agree that no warranties or representations have been made regarding the results I will achieve from this program. I understand that results are individual and may vary.
I acknowledge that I have thoroughly read this waiver and release and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against The 12 Training & Wellness, Inc. for your negligence or that of your employees, agent or contractors.
The 12 Training & Wellness, Inc. will require the below minor to work out under the direct supervision of their below-signed guardian.
Please PRINT legibly so that we can input your information into our system.
Printed Name of Minor
<CHILDFIRSTNAME> <CHILDLASTNAME> |
Date of Birth (Must be over 14 Years of Age
<CHILDBIRTHDAY> |
Printed Name of Parent or Guardian
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Date of Birth
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Address
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City
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Telephone Number
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