Jessica Ann - Fitness & Nutrition Drop In Signup
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The calendar contains Jessica Ann - Fitness & Nutrition's classes they allow drop-ins to attend. You can select as many classes as you'd wish to attend, and your fee will be adjusted accordingly.
Drop In Fee Details
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Jessica Ann - Fitness & Nutrition Liability Waiver (5396)
By signing this waiver you agree to participate in one or more physical fitness program(s)/class(es) sponsored by Jessica Ann – Fitness & Nutrition, which may include, but not necessarily be limited to, Boot Camp classes, cardiovascular training, weight lifting, yoga, dance and/or training of any kind by any affiliate, subsidiary or partnership of Jessica Ann – Fitness & Nutrition and/or Jessica Ann. Jessica Ann – Fitness & Nutrition made me fully aware that the fitness programs/classes
which Jessica Ann – Fitness & Nutrition offers and in which I desire to participate are of a nature and
kind that are extremely strenuous and can/may push me to the limits of my physical abilities. I the
undersigned recognize and understand that the programs/classes 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 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 any and all risks that I am exposing myself to as a result of my
participation in Jessica Ann – Fitness & Nutrition programs/classes and accept full responsibility for any
injury or death that may result from participation in any activity, class or physical fitness program. I
herby 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 Jessica Ann – Fitness & Nutrition. Jessica Ann –
Fitness & Nutrition informed me that there exists the possibility of adverse physical changes during an
exercise program, and I fully understand the same. Jessica Ann – Fitness & Nutrition informed me that
these changes could include abnormal blood pressure, fainting, disorder of heart rhythm, stroke, and in
very rare instances, heart attack or even death, and I fully understand the same. With my full
understanding of the above information, I agree to assume any and all risk associated with my
participation in Jessica Ann – Fitness & Nutrition fitness programs/classes.
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 Jessica Ann – Fitness &
Nutrition, and with my full understanding of all of the above, I hereby waive, release, remise and
discharge Jessica Ann – Fitness & Nutrition and its agents, officers, principals and employees and
volunteers, of any and all liability, claims, demands, actions or rights of action, or damages of any kind
related to, arising from, or in any way connected with, my participation in Jessica Ann – Fitness &
Nutrition fitness programs/classes, including those allegedly attributed to the negligent acts or
omissions of the above mentioned parties.
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 Jessica
Ann – Fitness & Nutrition 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.
I recognize that there is risk involved in the types of activities offered by Jessica Ann – Fitness &
Nutrition. 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 and costs to enforce this
agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold
harmless Jessica Ann – Fitness & Nutrition, 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 Jessica Ann – Fitness &
Use of picture(s)/film/likeness:
I agree to allow Jessica Ann – Fitness & Nutrition, its agents, officers, principals, employees and
volunteers to take a picture(s), film and/or likeness of me for advertising purposes. In the event I choose
not to allow the use of the same for said purpose, I agree that I must inform Jessica Ann – Fitness &
Nutrition of this in writing.
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.
Please answer the following questions
What is your first and last name?
What is your date of birth? Day/Month/Year
What is your telephone number?
What is your email?
Please enter emergency contact info (name and phone number).
I am in good physical condition to exercise with no current injuries.
My doctor has approved me for physical exercise.
I understand there are risks involved with exercise, including but not limited to; dizziness, fainting, physical injuries, death, etc.
I will inform my trainer of any current injuries or modifications required prior to the start of each class.
Please use your mouse/finger to sign your name
By clicking this checkbox you agree to online signature signing of this waiver
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