WAIVER AND RELEASE OF LIABILITY
Member Information:
Full Name: {name}
Date of Birth: {dob}
Address: {address}
Phone Number: {phone}
Emergency Contact:
Name: {contact_name}
Phone Number: {contact_phone}
Relationship: {contact_relation}
1. ACKNOWLEDGMENT OF RISK
I, {name}, understand that participation in physical activities, martial arts training, fitness classes, or any use of the facilities at this gym involves inherent risks, including but not limited to the risk of injury, illness, and in rare cases, death. I voluntarily choose to participate and assume all such risks.
Initials:
2. RELEASE OF LIABILITY
In consideration of being allowed to participate and use the facilities, I hereby release, waive, discharge, and hold harmless the gym, its owners, instructors, employees, volunteers, and agents from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, or injury that may be sustained by me or to any property belonging to me while participating in activities or using equipment on the premises.
Initials:
3. MEDICAL TREATMENT AUTHORIZATION
In the event of an emergency, I authorize gym staff to obtain medical treatment for myself (or my child, if under 18). I understand I am responsible for any associated costs.
Initials:
4. PHOTOGRAPHY & MEDIA RELEASE
I give permission for my (or my child’s) photo or video to be used for promotional purposes, including social media, website content, and printed materials.
Initials:
5. MINOR PARTICIPANT (if applicable)
If the participant is under 18 years of age, this waiver must be signed by a parent or legal guardian.
Name of Parent/Guardian:
Relationship to Participant:
6. MEMBER PORTAL
You may manage your membership, class bookings, and personal details through our portal:
{login_link}
SIGNATURE & CONFIRMATION
By signing below, I confirm that I have read and understood this waiver and agree to its terms voluntarily. I acknowledge that this waiver is legally binding.
Signature Name:
Date Signed: {sign_date}
Signature (draw or upload if applicable):
