CrossFit Winston Salem Liability Waiver (12694)
Waiver and Release of Liability
CrossFit Winston Salem
2529 Vieroy Dr
Winston Salem, NC 27103
Express assumption of risk: I am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls 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. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at CrossFit Winston Salem, I, the undersigned acknowledge that I have no physical impairments or illnesses that will endanger myself or others.
Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities available at CrossFit Winston Salem, I, the undersigned hereby release CrossFit Winston Salem, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of CrossFit Winston Salem, their principals, agents, employees, and volunteers. This agreement shall be binding upon me, my successors, representatives, heirs, executors, 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 full permission for any person connected with CrossFit Winston Salem to administer first aid deemed necessary, 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: The participant recognizes that there is risk involved in the types of activities offered by CrossFit Winston Salem. Therefore the participant accepts financial responsibility for any injury that 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 and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless CrossFit Winston Salem, 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 Winston Salem,
Rhabdomyolysis Release: Rhabdomyolysis (hereinafter referred to as "Rhabdo") can occur when an individual's physical activity is so intense that muscular cells begin to breakdown and the contents and/or remaining materials enter the bloodstream. Rhabdo may be caused by many other systemic or environmental causes. However, Exertional Rhabdo can occur in athletes of all levels of fitness, resulting in muscle cell destruction. The skeletal muscle breakdown impairs kidney function as those organs are unable to handle increased enzymes that are released into the bloodstream. This induces severe physiological changes in the body. The symptoms of Rhabdo include muscle pain, stiffness and extreme weakness, darkening of the urine (similar to the color of tea or cola), decreased urine output, altered mental status, swelling of the body part involved, either with or without pain. A Rhabdo symptom is pain out of proportion to the amount of soreness that one would generally expect, often producing pain much quicker than one would expect after a workout.
I understand that any concerns on my part that I am experiencing any of the symptoms of Rhabdo require immediate presentation to a hospital for emergency treatment. I acknowledge that no third party, either from the facility or otherwise, will be capable of monitoring my urine output or color, and it is my responsibility to be continually cognizant of this symptom and all other symptoms and to monitor them in my own body at all times. I agree that I will remove myself from participation and seek medical treatment of my own accord should I have any concerns regarding possible symptoms of Rhabdo. I understand that statistically individuals most likely to experience Rhabdo are those who are in good shape by general standards or who were previously in good physical shape. This includes individuals who were prior athletes. I acknowledge that often the more mentally tough an athlete is and the more athletic they were in the past or currently are, the greater the risk of exposure to Rhabdo.
I agree to monitor myself in a manner that is proportionate to the potential injury that can be occasioned by this condition. I acknowledge and understand that I am the only individual capable of determining if I am experiencing Rhabdo symptoms. I hereby agree and do willingly assume responsibility for any risks that I expose myself to and accept full responsibility for any injury or death that may result from participating in this significantly demanding physical activity. I for myself and on behalf of my heirs, assigns, personal representatives and/or next of kin, forever WAIVE, RELEASE, DISCHARGE and COVENANT NOT TO SUE and/or their officers, directors, representatives, partners, officials, principals, agents or employees, subsidiaries, or assigns, as well as their independent contractors.
I have read and understood 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.
PARENTAL CONSENT, (for participants under the age of 18) I, the undersigned parent or legal guardian of the child shown above, have read the above and understood the foregoing assumption of risk, and release of liability and agree to its terms on behalf of my child and myself. I understand that by signing below, I am giving up substantial rights on behalf of my child and myself.
Open Gym Rules
1. Open Gym is for CFWS athletes only. Please do not bring friends and family along to work out with you.
2. Members may work out on the small side during class times as space and equipment permits or on the big side if a class is not in session.
3. If you're working out during a class please be respectful of the coach on duty and the athletes in the class. Do not drop barbells or make noise that would distract members or interfere with coaches while they are in a teaching movement, explaining workouts, etc.
4. Open Gym is not a coached session, but there may be a coach on site. The athlete is responsible for their own safety.
5. Notify CFWS staff of any damage to equipment or the facility that occurs during Open Gym as soon possible.
6. Coaches always have priority to use the sound system, clock, and equipment for their classes.
7. The coach on duty has the right to stop any activity at any time.
8. Enter and exit through the front door outside of normal class hours. Please turn off any lights that were on and close all doors when you leave.
9. Please RSVP to open gym.
10. Basic gym etiquette still applies. Wipe down and put all your own equipment away after every use.
11. Open Gym hours may be modified at any time to accommodate classes, events, etc.
New members who go through the On Ramp program are required to have an active, three month commitment of which the first month must be the Unlimited Plan. If a member who goes through the On Ramp program cancels their membership within the first three months of their join date they will be required to pay a $150 cancelation fee. The $150 cancelation fee will be charged to the payment method on file. If that payment method is unable to be charged, the member will be responsible for paying the fee by other means within 30 days of canceling their membership. If the account is left unpaid the account will be turned over to a collections agency.