The following invoice shows what you will be charged as you select classes to drop into.
CONFIDENTIAL MEDICAL WAIVER
Fitness is an intensive exercise regime.
Towpath Fitness recommends that you consult with your physician prior to
participating in any exercise program.
CONSENT AND ASSUMPTION OF RISK
I and/or my minor children, agree to participate in one or more physical
fitness program(s)/classes(s) sponsored or conducted by Towpath Fitness. Towpath Fitness has made me fully aware that
the fitness programs/classes which Towpath Fitness offers and which I will
participate are of a nature and kind that are extremely strenuous. I, the undersigned, recognize and understand
that the programs/classes are not without varying degrees of risk which may
include, but are not limited to, the following:
serious injury or death due to negligence, on the part of myself, my
training partner, or other people around me; injury to musculoskeletal and/or
cardio respiratory systems, which can result in serious injury or death; serious
injury or death due to improper use or failure of equipment; or serious injury
or death due to a medical condition, whether known or unknown by me. I am aware that any of these above mentioned
risks may result in serious injury or death to me or my partner(s).
I willingly assume full responsibility for
any and all risks that I am exposing myself to as a result of my participation
in Towpath Fitness programs or classes and accept full responsibility for any
injury or death that may result from participation in any activity, class, or
physical fitness program sponsored or conducted by Towpath Fitness. Towpath Fitness informed me that there exists
the possibility of adverse physical changes during an exercise program, and I
fully understand the same. Towpath Fitness
informed that these changes could include, at a minimum, abnormal blood
pressure, fainting, disorder of heart rhythm, stroke, and in very rare
instances, heart attack or even death, and I fully understand the same. With my full understanding of the above
information, I agree to assume any and all risk associated with my
participation in Towpath Fitness fitness program(s) and class(s).
In full consideration of the above mentioned
risks and hazards and in full consideration of the fact that I am willingly and
voluntarily participating in the activities made available by Towpath Fitness,
and with my full understanding of all of the above, I hereby waive, release,
remise, and discharge Towpath Fitness and its agents, owners, officers,
principals, employees and volunteers, of any and all liability, claims,
demands, actions, or rights of action, or damages of any kind related to,
arising from, or in any way connected with, my participation in Towpath Fitness
program(s) or classes(s), including those allegedly attributed to the negligent
acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my
successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held
invalid, I agree that the remainder of the agreement shall remain in full legal
force and effect.
If I am signing on behalf of a minor child, I
also give full permission for any person connected with Towpath Fitness to
administer first aid deemed necessary, and in case of serious illness or
injury, I give permission to call for medical or surgical care for the minor
and to transport the minor to a medical facility deemed necessary for the wellbeing
of the minor.
Indemnification: I recognize that
there is risk involved in the types of activities offered by Towpath Fitness. I, therefore, accept financial responsibility
for any injury that I or the participant may cause either to him/herself 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 fees and cost to enforce
this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold
harmless Towpath Fitness, their principles, 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 Towpath Fitness.
and Video Release:
I grant to Towpath Fitness, its agents, officers, principals, employees, and
volunteers to the rights of my image, likeness and sound of my voice as
recorded on audio or video device for any lawful purpose without payment or
other consideration. I understand that
my image may be edited, copied, exhibited, published or distributed and waive the
right to inspect or approve the finished product wherein my likeness
appears. Additionally, I waive any right
to royalties or other compensation arising or related to the use of my image or
recording. In the event I choose not to allow the use of the same for the said purpose;
I agree that I must in inform Towpath Fitness in writing of my choice.
fully read and fully understand the foregoing Informed Consent and Assumption
of Risk, Waiver, Indemnification, and Photograph and Video Release. I understand that by signing this form I am
obligated to indemnify the parties named for any liability for injury or death
of any person and damage to property caused by my negligent or intentional act
or omission. I understand that by
signing this form I am waiving valuable legal rights. This Agreement shall be governed and interpreted by the
laws of the State of Ohio. Both
parties hereby unequivocally waive their right to a trial by jury and consent a
bench trial and to the personal and exclusive jurisdiction of a court of
competent jurisdiction located in Cuyahoga County, Ohio.