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, Jeffrey A. Kniep and Dawn P. Kniep 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
9. I acknowledge and agree that in regards to any appointment based event such as OnRamp, Personal Training, Nutrition Coaching, One on One Coaching etc, I will provide at least 4 hours notice of cancellation or be subject to a late cancellation fee as defined below:
- OnRamp - $20.00
- Personal Training - No refund of the fee already paid
- Nutrition Coaching - $20.00
- One on One Coaching - No refund of the fee already paid.
10. 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.
I further acknowledge that CrossFit Wichita has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
I further acknowledge that CrossFit Wichita 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, salon staff, and other salon clients and their families.
I voluntarily seek services provided by CrossFit Wichita 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 using the facilities at CFW.
I will not attend classes or meetings at CrossFit Wichita if any of the following are true:
* 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 contagiousby 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.
I hereby release and agree to hold CrossFit Wichita 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 of the salon, or that may otherwise arise in any way in connection with any services received from CrossFit Wichita. I understand that this release discharges CrossFit Wichita from any liability or claim that I, my heirs, or any personal representatives may have against the business or coaches 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 CrossFit Wichita This liability waiver and release extends to the salon together with all owners, partners, and employees.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.