The following invoice shows what you will be charged as you select classes to drop into.
Elite Fitness LLC, DBA CrossFit Bangor
CrossFit Bangor Waiver
CROSSFIT BANGOR STRONGLY RECOMMENDS THAT YOU CLEAR YOUR
PARTICIPATION IN ANY EXERCISE PROGRAM WITH YOUR PHYSICIAN. THE
PROTOCOLS OF THIS PROGRAM WILL INVOLVE YOU IN RELATIVELY HIGH
INTENSITY WORKOUTS AND IT IS IMPORTANT YOU UNDERSTAND THE
I _______________________agree to participate in physical training sessions instructed by CrossFit certified trainers Melinda Caldwell, or trainers affiliated with CrossFit Bangor.I am fully aware these fitness sessions are of a nature and kind that are extremely strenuous and will push me to the limits of my physical abilities.
I recognize and understand these training sessions are not without varying degrees of risk, which may include, but are not limited to the following: Injury to the musculoskeletal and or cardio respiratory systems, which can result in serious injury or death, injury or death due to negligence on the part of myself; my training partner, or other people around me, injury or death due to improper use or failure of equipment, or injury or death due to a medical condition, whether known or unknown by me. I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in this CrossFit training program and accept full responsibility for any injury or death that may result from my participation.
I hereby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by CrossFit Bangor. I understand there exists the possibility of adverse physical changes during an exercise program. I fully understand that these changes could include abnormal blood pressure, fainting, disorder of heart rhythm, stroke, and in very rare instances, heart attack or even death. I understand that certain prescribed medications may exacerbate these physiological changes and create an even greater risk of physical damage or death. With my full understanding of the above information, I agree to assume any and all risks associated with my participation in this CrossFit Fitness Program.
Elite Fitness LLC,
CrossFit Bangor Waiver
Release: In full consideration of the above mentioned risks and hazards and in full consideration of the fact that I am willingly and voluntarily participating in the activities made available by CrossFit Bangor, and with my full understanding of all of the above, I hereby waive, release, remise and discharge Melinda Caldwell and Elite Fitness LLC, Greg Glassman, CrossFit and its agents, officers, principals and employees and volunteers, of any and all liability, claims, demands, action or rights of actions, or damages of any kind related to, arising from, or in any way connected with, my participation in the CrossFit conditioning program. This agreement shall be binding upon me, my successors, representatives, heirs, executers, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give permission to administer the necessary first aid, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child.
Indemnification:I recognize there is risk involved in the types of activities offered by CrossFit. Therefore, I accept financial responsibility for any injury that I or the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above-mentioned parties, or anyone acting on their behalf be required to incur attorney's fees costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Melinda Caldwell and Elite Fitness LLC, CrossFit Incorporated, Greg and Glassman, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by CrossFit Bangor.
Payment: A signature on this waiver is a membership agreement between CrossFit Bangor and the undersigned member. The member understands and accepts the current rules and regulations of CrossFit Bangor and any amendments or supplementation of the current rules. Member understands and accepts that they are responsible for their chosen membership plan by monthly credit card or EFT (electronic funds transfer). Member understands and accepts that all "On-Ramp” membership programs have a mandatory three-month membership plan that begins 30 days from the start of their first "On-Ramp” class and that the member will be billed for three month’s membership regardless of class attendance. Member accepts that no refunds are made for services purchased and that clients with monthly memberships must give CrossFit Bangor at least 30 days’ notice prior to their billing date to cancel their membership plan.
Waiver of Liability CrossFit Bangor OPEN GYM attendance.
PLEASE NOTE: This waiver of Liability, Release, Acknowledgement of Risk, and Indemnification Agreement (“Waiver Agreement”) is intended to be, and is, legally binding.
I, __________________ have volunteered to participate in a fitness program provided to me by CrossFit Bangor (“CF-L1/CF -L2”), which may include, but may not be limited to, resistance training and aerobic or cardiovascular exercises with the use of objects such as but not limited to barbells, bumper plates of varied weight, dumbbells of varied weight, bodyweight movements. In consideration of Coaches’s agreement to instruct and train me, I do here now and forever release and discharge and hereby hold harmless CrossFit Bangor and his respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from. THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT BELONGING TO TRAINER OR TO MYSELF THAT MAY MALFUNCTION OR BREAK; (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT; (3) AND/OR NEGLIGENT INSTRUCTION OR SUPERVISION.
I, __________________ , have been informed of, understand and am aware that any exercise program, whether or not requiring the use of exercise equipment, is a potentially hazardous activity. I also have been informed of, understand and am aware that any exercise and/or fitness activities involve a risk of injury, as well as abnormal changes in blood pressure, fainting, and a remote risk of heart attack, stroke, other serious disability or death, and that I am voluntarily participating in these activities and using equipment and machinery with full knowledge, understanding and appreciation of the dangers involved. I hereby agree to expressly assume and accept any and all risks of injury, regardless of severity, or death. I have been advised that an examination by a physician should be obtained by anyone prior to commencing a fitness and/or exercise program, or initiating a substantial change in the amount of regular physical activity performed.
If I, __________________ have chosen not to obtain a physician’s consent prior to beginning this fitness program with Trainer, I hereby agree that I am doing so solely at my own risk. In any event, I acknowledge and agree that I assume the risks associated with any and all fitness related activities and/or exercises in which I participate.
Screen for COVID-19 symptoms for all entrants, including employees, visitors, and customers upon arrival to the gym or fitness center. The most effective screening method is to ask patrons the following questions to screen for illness:
I, ___________________ also comply and understand my risk associated with COVID-19 and MUST answer “NO” to all of the following criteria when I RSVP for a class, check in to open gym or enter the facility. This list includes, but is not limited to the following (please see the Maine CDC website for updates):
• Have you had a cough or sore throat?
• Have you had a fever or do you feel feverish?
• Do you have shortness of breath?
• Do you have loss of taste or smell?
• Have you been around anyone exhibiting these symptoms within the past 14 days?
• Are you living with anyone who is sick or quarantined?
• Have you been out of the state in the last 14 days?
Face coverings are required when physical distancing is difficult to maintain.
Members potentially at high risk for COVID-19 should work with their primary care provider to determine if utilizing a gym or fitness center is reasonably safe for them.
If travelling outside the state of Maine, I must adhere to the Maine CDC recommendations 1) getting a negative COVID-19 test within 72 hours; or 2) maintaining compliance with a 14-day quarantine upon arrival in Maine as well as any requirements laid out by the state of Maine. For the most up to date protocols, please refer to the Keeping Maine Healthy website.
I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS FORM IN ITS ENTIRETY AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST TRAINER FOR YOUR NEGLIGENCE OR THAT OF YOUR EMPLOYEES, AGENTS, OR CONTRACTORS.
This form is an important legal document that explains the risks you are assuming by beginning an exercise program. It is critical that you have read and understand this document completely. If you do not understand any part of this document, it is your ultimate responsibility to ask for clarification prior to signing it.
I have fully read and fully understand the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.
Participant’s Signature: (electronic signature next page)
Legal Guardian’s Signature: (electronic signature next page)
(If participant are under 18 years old)