Please provide a medical release authorization from your physician if you have any known medical conditions that may affect you during physical activities. WAIVER OF CLAIMS AND RELEASE OF LIABILITY READ CAREFULLY-THIS AFFECTS YOUR LEGAL RIGHTS In consideration of being permitted to participate in the training and physical activities associated with CrossFit Wichita training regimen, which includes intense weight training, cardiovascular conditioning and endurance, conducted and organized by CrossFit Wichita of 535 S. St. Francis, Wichita, Ks. 67202, Belen Puga and any other CrossFit Wichita association, hereinafter collectively referred to as "CrossFit Wichita Programming,” and in recognition that CrossFit Wichita training is an inherently DANGEROUS ACTIVITY, Member/Participant and his/her personal representatives, guardians, assigns, heirs, and next of kin, hereinafter collectively referred to as "Member,” hereby covenants not to sue, waives, damage, and any claim or damage therefore on account of any injury to the person or property or resulting in permanent injury or death of the Member, or in contract, WHETHER CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR STRICT LIABILITY OF CROSSFIT WICHITA, ITS EMPLOYEES OR INSTRUCTORS OR OTHERWISE, WHILE MEMBER IS INVOLVED IN ACTIVITIES AT CROSSFIT WICHTA OR ANY CROSSFIT WICHITA RELATED FUNCTION, INCLUDING ANY INJURY INVOLVING EQUIPMENT FAILURES.
Liability and Consent Form
1. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral
instructions or directions given by CrossFit Wichita or its employees, representatives or agents.
2. I agree to indemnify and defend from suit CrossFit Wichita or any of its agents or assigns in the event
of suit. I agree to waive, release, and forever discharge CrossFit Wichita, its officers, agents,
employees and representatives against all claims, causes of actions, damages, judgments, costs or
expenses, including attorney fees and other litigation costs, which may in any way arise from my or
my family’s use of or presence upon the facilities and from any activity associated with any injury to
me or my family related to activities with CrossFit Wichita.
3. I agree to further release CrossFit Wichita, its owners, instructors and employees from any claim of
Liability resulting from administering first aid treatment or service rendered to Member during his
participation in CrossFit Wichita activities.
4. Member herby agrees to personally provide for any medical expenses, which may be incurred or
Necessitated as a result of any injury sustained while participating in an CrossFit Wichita class, during
Training at, or performing for, or at CrossFit Wichita.
5. For promotional purposes, Member gives CrossFit Wichita authorization to post on their website and
Facebook page and any other social media photos of student and other for use of media/film
Production taken from the workout sessions and while at the premises of CrossFit Wichita.
6. I agree that refunds and carryovers are disallowed. All CrossFit Wichita class sessions must be used
Within 31 days from first visit.
7. Any legal or equitable claim that may arise from participation in the above shall be resolved under
8. I acknowledge that any requests for termination of membership need to be submitted to the office at least 7 days prior to monthly membership renewal date to avoid a $35 cancellation fee
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.