KIDS WAIVER & RELEASE - Explicit CrossFit

EXPLICIT CROSSFIT KIDS WAIVER & RELEASE

PARTICIPANT NAME

DATE OF BIRTH

GUARDIAN NAME

ADDRESS

Phone

ADDITIONAL EMERGENCY CONTACT

Explicit CrossFit Kids Code of Conduct: I will respect myself by giving my best effort and maintaining a positive attitude. • I will respect fellow CrossFit Members by positivity encouraging and supporting others. • I will refrain from any negative behavior towards others. • I will respect the coaches by following their instructions, trusting their recommendations, and being coachable. • I will respect the facility and equipment by keeping it clean- throwing away trash, and putting equipment back to where I found it. • I will respect everyone’s safety by getting to class on time for proper warm up. I will wear appropriate workout clothing and shoes. I will handle equipment carefully and will not use until instructed to do so by a coach. • I understand the Explicit CrossFit Kids disciplinary policy- 3 strike rule. For violations against this Code of Conduct or there will be a strike documented. If 3 strikes are received the membership will be revoked. • The #1 PRIORITY is to maintain a SAFE and FUN environment for all.

Waiver and Release of Liability: Express assumption of risk: I, the undersigned, 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 even death; injury or death due to negligence on the part of the participant, my training partner, or other people around me; injury or death due to improper use or failure of equipment; strains and sprains. I am aware that any of these above mentioned risks may result in serious injury or death to the participant and or my partner(s). I willingly assume full responsibility for the risks that I am exposing the participant to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of EXPLICIT CROSSFIT. I acknowledge that the participant has no physical impairments, injuries, or illnesses that will endanger them or others.

Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that the participant willingly and voluntarily participates in the activities offered by EXPLICIT CROSSFIT, I, the undersigned hereby release EXPLICIT CROSSFIT 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 participation in this activity, 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 EXPLICIT CROSSFIT 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: I recognize that there is risk involved in the types of activities offered by EXPLICIT CROSSFIT. Therefore I accept 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 EXPLICIT CROSSFIT, 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 in respect of activities offered by EXPLICIT CROSSFIT, at the main building or elsewhere. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to the main building, and/or any area selected for training by EXPLICIT CROSSFIT

Child Safety: Children under 12 are not allowed in CrossFit classes unless it is a CrossFit Kids Class or special event specified by Explicit CrossFit. I understand that children under the age of 12 must remain in designated kids areas, contained (walker/stroller/playpen, etc) if applicable. I understand that children are not allowed on any equipment, unless they are part of CrossFit Kids Class and instructed by a coach. A parent or guardian must accompany children at all times.

List all current medications:

Has your child ever been restricted from physical activity due to medical reasons? Please explain:

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.

Photo Release: I hereby grant Explicit CrossFit permission to use my child’s photograph/video image in any and all publications for CrossFit, Inc. or Explicit CrossFit , including on their websites, social media pages, or any other publications, without payment or any other consideration in perpetuity. I hereby authorize Explicit CrossFit to edit, alter, copy, exhibit, publish or distribute all photos and images. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my child’s photo appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video images.

EXPLICIT CROSSFIT KIDS WAIVER & RELEASE

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