Liability Waiver

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Liability Waiver

First and Last Name *

Street Address (City, State and Zip Code) *

Phone

Date of Birth

YYYY

Email Address *

Emergency Contact Name, Phone Number and Relationship *

Check Box To Agree *

By checking this box, I understand physical activity involves certain risks and being aware of my own health/physical condition understand that my participation may be injurious to my health. While participating in physical activity with Eye In Me Fitness or it's sister entity, I agree to disclose any physical limitations, disabiliities, ailments, or impediments that affect my ability to participate in any fitness programs.

Required

Check Box To Agree *

Having such knowledge, I hereby release Eye In Me Fitnes, it's agents, an successors from liability for accidental injury or illness. I have carefully read this waiver and fully understand that it is a release of liability, express assumption of risk and indemnity agreement. I am aware and agree that by exucuting this waiver and release, I am giving up my right to bring a legal action or assert a claim aginst trainer from trainer's negligence, or for any defective product used while recieving personal training from trainer. I have read and voluntarily signed the waiver and release and further agree that no oral representations, statements, or inducement apart from the foregoing written agreemnt has been made.

Required

Today's Date of Submission *

YYYY

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