Stamina Fitness Training

Waiver


RELEASE OF LIABILITY, WAIVER OF CLAIMS,
ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

PLEASE READ CAREFULLY BEFORE SIGNING!
THIS IS A RELEASE OF LIABILITY & WAIVER OF CERTAIN LEGAL RIGHTS INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION


1: I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.

2: I further acknowledge that STAMINA has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

3: I further acknowledge that STAMINA cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, STAMINA staff, and other STAMINA clients and their families.

4: I voluntarily seek services provided by STAMINA and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my class/appointment.

I attest that:

  • I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
  • I have not traveled internationally within the last 14 days.
  • I have not traveled to a highly impacted area within the United States of America in the last 14 days.
  • I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
  • I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non-contagious by state or local public health authorities.
  • I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

 

5: I hereby consent to the photographing, recording, reproduction of any other manner (including the use of video) of my likeness, voice and/or activities and further authorize STAMINA to make unlimited use of company promotions, including, but not limited to, broadcasting of reproductions over the Internet and social media. I understand that I will not receive any monetary compensation now or in the future for participating. I do hereby release and hold harmess Stamina, its officers, and employees from any claims.

6: Stamina Fitness Training recommends that you speak to your medical provider before participating in our Workouts, Zoom Classes or YouTube/Social Media recorded classes.  Please listen to your body and seek medical advice if you have any concerns about your individual needs.  No information in any of our videos should be taken as medical or health advice.  By performing or taking part in any of our workouts, you agree you do so at your own risk, are voluntarily participating in the activities, assume all risk of injury to yourself and you agree to release & hold harmless Stamina Fitness Training, LLC & its associates from all liability pertaining to any injuries or issues related to our workouts.

7: I understand that this Agreement will apply for each and every day Participant engages in any Activity at Stamina or online as part of our Zoom Classes or YouTube/Social Media videos.

I hereby release and agree to hold STAMINA harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act by STAMINA, or that may otherwise arise in any way in connection with any services received from STAMINA. I understand that this release discharges STAMINA from any liability or claim that I, my heirs, or any personal representatives may have against STAMINA with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from STAMINA. This liability waiver and release extends to STAMINA together with all owners, partners, and employees.

I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, MY PARENT/LEGAL GUARDIAN HAS SIGNED THE FORM.

Registered Business address: 

Stamina Fitness Training, 40 Greenfield Avenue, San Anselmo, CA 94960

San Anselmo Business License:

12392

Participant Name:

D.O.B:

Leave this empty:

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Signature Certificate
Document name: Waiver
lock iconUnique Document ID: fab1a7b987438f172cc0b82599870da3c3a6afab
Timestamp Audit
April 24, 2021 9:25 am PDTWaiver Uploaded by Scott Fay - [email protected] IP 2601:647:0:bc40:e06f:8ac4:d26f:eb28