RELEASE OF LIABILITY AND WAIVER AGREEMENT FORM Name * First Name Last Name Email * Start Date * MM DD YYYY Address * City * Zip Code * Phone * (###) ### #### Emergency Contact Person * First Name Last Name Emergency Phone * (###) ### #### Relationship to the contact * I, the undersigned, * being aware of my own health and physical condition, and having knowledge that my participation in any exercise program may be injurious to my health, am voluntarily participating in a physical activity. Having such knowledge, I hereby acknowledge this release, any representatives, agents, and successors from liability for accidental injury or illness which I may incur as a result of participating in the said physical activity. I hereby assume all risks connected therewith and consent to participate in said program. I agree to disclose any physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in said fitness program. Thank you for the filling the waiver liability form, We have received your information.
