CrossFit Training Yard
General Registration Form & Confidential Medical Waiver
In Case of an Emergency:
I give full permission for any person connected to CrossFit Training Yard to administer first aid deemed necessary in case of serious illness or injury.
Informed Consent / Assumption of Risk:
CrossFit Training Yard strongly recommends that you clear your participation, in any exercise program, you’re your physician. CrossFit Training Yard’s services are not a substitute for professional medical advice. All known health and/or medical issues must be cleared by a physician for full participation.
I understand that exercises in these training sessions can be strenuous at times. There is an inherent risk in any exercise program that, while providing great health benefits, can also cause unintentional health issues. While CrossFit Training Yard takes the utmost care to provide the safest program possible, I recognize and understand these training sessions are not without varying degrees of risk. Although extremely rare, these risks may result in critical injuries up to and including death. Negligent and/or accidental acts committed by either myself or another could also cause the same consequences.
I willingly assume full responsibility for any and all risks that I am exposing myself to as result of my participation in Crossfit by CrossFit Training Yard and accept full responsibility for any injury or death that may result from my participation.
With my full understanding of the above information. I agree to assume any and all risks associated with my participation in this strength and conditioning program.
In full consideration of the above mentioned risks and hazards, I hereby waive, release, remise and discharge Rebecca Miller, Eric Miller, CrossFit Training Yard and STRONGBOX LLC, Crossfit Incorporated, and any agents, officers, principals, employees and volunteers of above mentioned entities, of any and all liability, claims, demands, action or rights of actions, or damages of any kind related to, arising from, or in any way connected with my participation in Crossfit by CrossFit Training Yard.
I hereby give permission for images of me, captured during regular and special activities, through video, camera and digital camera, to be used solely for the purposes of CrossFit Training Yard, Crossfit Incorporated, and /or Crossfit Kids promotional material publications and/or website, and waive any rights of compensation or ownership thereto. Last names of minors will not be given or posted on the internet or website.
I have fully read and fully understand the forgoing assumption of risk and release of liability and I understand that by signing it obligates me to indemnify the parties named from liability resulting in injury and/or death. I also take full responsibility for any property damage, injury or death caused by me whether intentional or unintentional. I understand that by signing this form I am waiving valuable legal rights and I do so freely.
RELEASE AND WAIVER
In consideration for continued access to the training facility
identified herein as CrossFit Training Yard, I do hereby acknowledge the significant risks
associated with the physical training and programing at this facility. I acknowledge and attest to having fully and carefully read and reviewed this "RELEASE AND WAIVER” including allsubparagraphs prior to engaging in any physical activity at this facility.
Rhabdomyolysis (hereinafter referred to as "Rhabdo”) can occur when an individual’sphysical activity is so intense that muscular cells begin to breakdown and the contents
and/or remaining materials enter the bloodstream. Rhabdo may be caused by many other
systemic or environmental causes. However, Exertional Rhabdo can occur in athletes ofall levels of fitness, resulting in muscle cell destruction. The skeletal muscle breakdown
impairs kidney function as those organs are unable to handle increased enzymes that are
released into the bloodstream. This induces severe physiological changes in the body.
The symptoms of Rhabdo include muscle pain, stiffness and extreme weakness,
darkening of the urine (similar to the color of tea or cola), decreased urine output, altered
mental status, swelling of the body part involved, either with or without pain.
I understand and have been advised that generally the pain that is referred to as a Rhabdo
symptom is pain out of proportion to the amount of soreness that one would generally
expect, often producing pain much quicker than one would expect after a workout.
I understand that any concerns on my part that I am experiencing any of the symptoms of Rhabdo require immediate presentation to a hospital for emergency treatment. I
acknowledge that no third party, either from the facility or otherwise, will be capable of
monitoring my urine output or color, and it is my responsibility to be continually
cognizant of this symptom and all other symptoms and to monitor them in my own body
at all times. I agree that I will remove myself from participation and seek medical
treatment of my own accord should I have any concerns regarding possible symptoms of
I acknowledge and understand that all individuals engaged in demanding workouts are
potentially exposing themselves to Rhabdo or other injuries/negative physical results.
However, I understand that statistically individuals most likely to experience Rhabdo are
those who are in good shape by general standards or who were previously in good
physical shape. This includes individuals who were prior athletes and/or prior military
personnel, law enforcement or firefighters. I acknowledge that often the more mentally
tough a potential athlete is and the more athletic they were in the past or currently are, the
greater the risk of exposure to Rhabdo.
I acknowledge and fully understand that statistically the chances of me developing
Rhabdo are extremely slight, but I likewise appreciate the necessity that I be aware of the symptoms of this condition. I agree to monitor myself in a manner that is proportionate to
the potential injury that can be occasioned by this condition. I acknowledge and
understand that I am the only individual capable of determining if I am experiencing
Rhabdo symptoms. I hereby agree and do willingly assume responsibility for any risks
that I expose myself to and accept full responsibility for any injury or death that may
result from participating in this significantly demanding physical activity.
With the opportunity to fully inform myself about Rhabdo and the risks thereof, I
knowingly and freely assume and accept all such risks both known and unknown. I
assume full responsibility and all risks from my participation in any physical activity at
the facility. I for myself and on behalf of my heirs, assigns, personal representatives
and/or next of kin, forever WAIVE, RELEASE, DISCHARGE and COVENANT NOT
TO SUE CrossFit Training Yard / Strongbox LLC and/or their officers, directors, representatives,
partners, officials, principals, agents or employees, subsidiaries, or assigns, as well as
their independent contractors.
I understand that a method of payment (ACH/CC) will be kept on file and automatically charged on the monthly basis for all memberships. Any changes to my membership will require a 30 day notice, including holds and cancellation, regardless of the method of payment.