Day Pass - Workout Warehouse

READY TO HIT THE FLOOR RUNNING?

You’re about to grab a one-day pass to Workout Warehouse. Before you get full access, we just need you to complete a quick waiver.

WORKOUT WAREHOUSE WAIVER/RELEASE OF LIABILITY FORM FOR ONE DAY USE

11907 E. Empire #F Spokane Valley, WA 99206 (509) 795-0468

GENERAL RELEASE, WAIVER OF LIABILITY AND ASSUMPTION OF THE RISK

(Inherently Dangerous Activity)

DAY PASS LIABILITY WAIVER

PARTICIPANT INFORMATION:

Last Name *

First Name *

DOB *

Age *

Age verification *I confirm that I am at least 18 years old.

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone *

Email Address *

EMERGENCY CONTACT INFORMATION:

First Name *

Last Name *

Relationship *

Primary phone *

Secondary Phone

ACCESS OPTIONS:

ACCESS TYPE *I am working with a personal trainer (membership required)I am working out independently

NAME OF PERSONAL TRAINER: *

PAYMENT METHOD AUTHORIZATION:

I agree to authorize Workout Warehouse to charge my selected payment method.

Name on Card: *

Card Number: *

Expiration Date: *

CVV: *

In consideration of the privileges granted to me (the participant) in connection with my voluntary participation in individual and/or group physical exercise, sessions, programs, or activities with Workout Warehouse which may involve gymnastics, fitness, dance, kickboxing, yoga, and martial arts, as well as the use of exercise equipment , amenities, and facilities owned and/or operated by Workout Warehouse, it’s representatives, or it’s contractors (collectively, the “activities”), the participant (individually or by his or her parent/guardian, if the participant is a minor) do hereby release, defend, hold harmless and indemnify Workout Warehouse, it’s shareholders, directors, officers, agents, faculty, volunteers, employees, and all others from and against any and all liability, claims, charges, demands, expenses, fees, fines, penalties, losses, suits, proceedings, actions and costs thereof (including attorneys’ fees and court costs for all actions and appeals therefrom), for judgements, injuries, including those resulting in death, damages, liabilities, at law or in equity, of any kind and nature, resulting from or arising out of mt participation in the activities. *

I understand that Activities in which I will be engaged may be dangerous and may carry some inherent risk, and I voluntarily choose to assume those risks. I also recognize that by participating in the Activities I may experience health risks including, but not limited to, death, or disability, and I willfully assume those risks. I assume full responsibility before and after my participation, for my choices and consent to release Workout Warehouse from liability. THIS GENERAL RELEASE, WAIVER OF LIABILITY AND ASSUMPTION OF THE RISK IS BINDING ON THE PARTICIPANT AND/OR HIS OR HER PARENT OR LEGAL GAURDIAN, PERSONAL REPRESENTATIVES, HEIRS AND ASSIGNS. I ACKNOWLEDGE, BY SIGNING BELOW, THAT I AM EITHER OVER THE AGE OF 18 OR THIS RELEASE IS BEING ENTERED INTO BY MY PARENT OR LEGAL GAURDIAN. *

In the event of accident or emergency, I hereby authorize Workout Warehouse to transport the Participant, or cause the Participant to be transported to the hospital for medical treatment and I hold Workout Warehouse and it’s representatives harmless with regard to same. I hereby agree to be fully and solely responsible for all medical which may be incurred as a result of the Participant’s participation in the Activities. *

I acknowledge that Workout Warehouse retains the right to use any photographs, video, motion picture recordings or any other recording of events for publicity, advertisement or any other legitimate purpose and I hereby consent to such use. *

Electronic Signature *

Date