BLOOMINGTON UNITED FOR FITNESS (BUFF) Informed Consent and Waiver/Release

 

INFORMED CONSENT

I, _________________________________________, through the purchase of training sessions, have agreed to voluntarily participate in an exercise program, including, but not limited to, strength training, flexibility development, and aerobic exercise, under the guidance of Monica Zerfas, Bloomington United For Fitness (BUFF).  I hereby stipulate and agree that I am physically and mentally sound and I am able to undertake a general fitness-training program.

 

I understand and am aware that physical-fitness activities, including the use of equipment, are potentially hazardous activities.  I am aware that participating in these types of activities, even when completed properly, can be dangerous.  I agree to follow the instructions issued by the trainer.  I am aware that potential risks associated with these types of activities include, but are not limited to: death, fainting, disorders in heartbeat, serious neck and spinal injuries that may result in complete or partial paralysis or brain damage, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the musculoskeletal system, and serious injury or impairment to other aspects of my body, general health and well-being. 

 

WAIVER AND RELEASE

Although Monica Zerfas, Bloomington United For Fitness, will take precautions to ensure my safety, I expressly assume and accept sole responsibility for my safety and for any and all injuries that may occur.  In consideration of the acceptance of this entry, I, for myself and for my executors, administrators, and assigns, waive and release any and all claims against Monica Zerfas, Bloomington United For Fitness and any of their staffs, officers, officials, volunteers, sponsors, agents, representatives, successors, or assigns and agree to hold them harmless from any claims or losses, including but not limited to claims for negligence for any injuries or expenses that I may incur while exercising or while traveling to and from training sessions.   These exculpatory clauses are intended to apply to any and all activities occurring during the time for which I have contracted with Monica Zerfas, Bloomington United For Fitness. 

 

I represent and warrant I am signing this agreement freely and willfully and not under fraud or duress.

 

________________________________________________________________________Date:_________________