Waiver &  Pre-exercise Questionnaire

Some clients may need to be referred to health care professionals for a medical release prior to commencing physical activity with Renee Browne Fitness and Black Dragon Kai Combat Systems.

 
  • I agree that participating in this physical activity is done so at my own risk
  • I accept all risks and release the trainer, their agents, affiliates, employees, members, sponsors, promoters, and any other person or body directly or indirectly associated with the trainer, against all liability (including liability for their negligence, and the negligence of others), claims, demands, and proceedings arising from, or associated to my participation in the activity
  • This release and indemnity continues forever and binds my heirs, successors, executors, personal representatives, and assigns
  • I acknowledge that participating in this physical activity may involve a risk of injury, or even death
  • I attest to being physically capable of participating in this physical activity and have not been advised otherwise by a medical practitioner
  • I am not aware of any medical condition, injury, or impairment that will be detrimental to my health if I participate in this physical activity
  • I will advise my trainer/coach/instructor immediately if I become aware of any medical condition, injury, or impairment in the future
  • I accept the risks despite these conditions and am still, and always will be, under the terms of this agreement
  • I certify that I am 18 years or older and have read and fully understand this document
  • Or, as a parent / guardian, I agree to the above for myself and on behalf of the participant.
 
Name
Name