I agree to the below liability waiver.
I, ______________________________, through the purchase of training sessions, have agreed to voluntarily participate in an exercise program, including, but not limited to, strength training, flexibility development, and aerobic exercise, under the guidance of Molly Kujawski. I hereby stipulate and agree that I am physically and mentally sound and currently have no physical conditions that would be aggravated by my involvements in an exercise program. I have provided verification from a licensed physician that I am able to undertake a general fitness-training program.
I understand and am aware that physical-fitness activities, including the use of equipments, are potentially hazardous activities. I am aware that participating in these types of activities, even when completed properly, can be dangerous. I agree to follow the verbal instructions issued by the trainer. I AM AWARE THAT POTENTIAL RISKS ASSOCIATED WITH THESE TYPES OF ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO: DEATH, FAINTING, DISORDERS IN HEARTBEAT, SERIOUS NECK AND SPINAL INJURING THAT MAY RESULT IN COMPLETE OR PARTIAL PARALYSIS OR BRAIN DAMAGE, SERIOUS INJURY TO VIRTUALLY ALL BONES, JOINTS LIGAMENTS, MUSCLES, TENDONS, AND OTHER ASPECTS OF THE MUSCULOSKELETAL SYSTEM, AND SERIOUS INJURY OR IMPAIRMENT TO OTHER ASPECTS OF MY BODY, GENERAL HEALTH, AND WELL-BEING.
I understand that I am responsible for my own medical insurance and will maintain that insurance throughout my entire period of participation with Molly Kujawski. I will assume any additional expenses incurred that go beyond my health coverage. I will notify Molly Kujawski of any significant injury that requires medical attention (such as emergency care, hospitalization, etc.).
Molly Kujawski or I will provide the equipment to be used in connection with workouts, including, but not limited to, benches, dumbbells, barbells, and similar items. I represent and warrant that any and all equipment I provide for training sessions is for personal use only. Molly Kujawski has not inspected my equipment and has no knowledge of its condition. I understand that I take sole responsibility for my equipment. I acknowledge that, although Molly Kujawski takes precautions to maintain the equipment, any equipment may malfunction and/or cause potential injuries. I take sole responsibility to inspect any and all of my or Molly Kujawski's equipment prior to use.
Although Molly Kujawski will take precautions to ensure my safety, I expressly assume and accept sole responsibility for my safety and for any and all injuries that may occur. IN CONSIDERATION OF THE ACCEPTANCE OF THIS ENTRY, I, FOR MYSELF AND FOR MY EXECUTORS, ADMINISTRATORS, AND ASSIGNS, WAIVE AND RELEASE ANY AND ALL CLAIMS AGAINST MOLLY KUJAWSKI AND ANY OF HER STAFFS, OFFICERS, OFFICIALS, VOLUNTEERS, SPONSORS, AGENTS, REPRESENTATIVES, SUCCESSORS, OR ASSIGNS AND AGREE TO HOLD THEM HARMLESS FROM ANY CLAIMS OR LOSSES, INCLUDING BUT NO LIMITED TO CLAIMS FOR NEGLIGENCE FOR ANY INJURIES OR EXPENSES THAT I MAY INCUR WHILE EXERCISING OR WHILE TRAVELING TO AND FROM TRAINING SESSIONS. These exculpatory clauses are intended to apply to any and all activities occurring during the time for which I have contracted with Molly Kujawski.
If a court of competent jurisdiction finds any provision to be invalid for any reason, the remainder of these provisions shall be valid and enforceable per their terms.
I represent and warrant I am signing this agreement freely and willfully and not under fraud or duress.
THIS FORM IS AN IMPORTANT LEGAL DOCUMENT THAT EXPLAINS THE RISKS YOU ARE ASSUMING BY CHOOSING TO BEGIN AN EXERCISE PROGRAM. IT IS CRITICAL THAT YOU HAVE READ AND UNDERSTOOD THIS DOCUMENT COMPLETELY. IF YOU DO NOT UNDERSTAND ANY PART OF THIS DOCUMENT, IT IS YOUR ULTIMATE RESPONSIBILITY TO ASK FOR CLARIFICATION BEFORE SIGNING IT. INTENDING TO BE BOUND BY THIS COMPLETE WAIVER AND DISCLAIMER IN FAVOR OF MOLLY KUJAWSKI, I HEREBY AFFIX MY SIGNATURE HERETO.
By signing your first and last name below, you are agreeing to these terms. *
__________________________________________________________________ Date: _____________
I have read the above statement and accept the terms of the waiver.