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CONSENT FORM FOR USE OF TOTAL FITNESS

NOTICE OF ASSUMPTION OF RISK - WAIVER AND RELEASE

Fitness Centre Policy

I, the undersigned parent/guardian of the minor participant named above give my permission for said individual to exercise in the Fitness Centre at Total Fitness Gym having met the Fitness Centre Policy requirements listed above.

I understand that engaging in any physical exercise activity or using the Fitness Centre for any purpose may pose a serious risk to health or cause death. I will read and complete the Par-Q Physical Activity Readiness Questionnaire and if the answer is “YES” to any question, I understand that it is strongly recommended that a physician be consulted prior to say minor participant commencing an exercise program or using the Fitness Centre. I understand that after starting to use the Fitness Centre, if said minor participant notices any changes in physical condition that may indicate a health risk by continued use of the Fitness Centre, it is strongly recommended that a physician be consulted to ensure that it is appropriate to continue to use the Fitness Centre. I agree that if said minor participant uses the Fitness Centre, they do so at their own risk.

I, on behalf of myself, my heirs, and executors, hereby release and discharge and covenant not to pursue Total Fitness Gym, its agents, managers and employees, from and for any and all liability for all loss or damages, and any claims or demands therefore, on account of injury to said minor participant’s person or property, including death, arising from use of the Fitness Centre; and I agree to indemnify and hold Total Fitness Gym and its agents harmless from any loss, liability, damage, or cost, including reasonable attorney fees that may occur as a result of or due to said minor participant’s use of the Fitness Centre.

PHOTO/VIDEO RELEASE: I give my permission to have photos and/or video recordings taken of me or my children for publicity purposes during Total fitness gym activities even though we will not receive compensation of any kind for appearing in such photos or video recordings. I have read, understood, and voluntarily accepted the conditions of the waiver of liability / release and the photo release printed above.

I have read, understood and agree to the notice of assumption of risk - waiver and release for my minor participant.

Clear

    (Parent / Guardian)


Clear

    (Minor Participant)