RELEASE OF LIABILITY

 

CLIENT INFORMATION:

NAME: 

ADDRESS: 

CELL PHONE: 

HOME PHONE: 

EMAIL: 

AGE: 

HOW DID YOU HEAR ABOUT ME?: 

 

ELLIGIBILITY

  • I have enrolled in a program of strenuous physical activity including but not limited to walking, running, weight training, aerobics, and the use of various conditioning and exercise equipment designed, offered, recommended, and/or supervised by Pro Cryo Plus.
  • I hereby affirm that I am in good physical condition and do not suffer from any disability that would prevent or limit my participation in this program.

Initials:

 

RELEASE OF LIABILITY/ASSUMPTION OF RISK

  • I fully understand that I may suffer injury as a result of my participation in the program and I hereby release Pro Cryo Plus from all liability now or in the future, including but not limited to medical expenses, lost wages, pain and suffering, that may occur by reason of heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/foot, injuries, and any other illness, soreness, or injury, however caused, whether occurring during or after my participation in the program or use of the strength and conditioning equipment and facilities, regardless of fault.

Initials:

 

By signing the document, I attest, contract, acknowledge, and agree that I am legally bound by its content and it is continuously valid indefinitely.

 

Printed Name: 

Signature: 

Date: 

RICH PUTNICK (Rich Putnick Authorized Signature)

Date: