Waivers & Forms
In consideration of my desire to engage in an exercise program at Schock Fitness, LLC,
I understand and agree to the following:
Participation by me in this activity is entirely voluntary. I fully understand what I am undertaking and signing up to participate in. Before I engage in any activity I may be asked to complete a health history form as well as an evaluation to determine my risk of participating in exercise as well as areas that need to be addressed. I am aware that I should see my physician, and get clearance from them before exercising.
I understand that the possibility exists that certain changes may occur during exercise. They may include muscular strains, sprains, and delayed onset muscles soreness, abnormal blood pressure, fainting, disturbances of heart rhythm, and very rare instances of heart attack or death.
I understand that a program of regular exercise for the heart, lungs, muscles and joints, has many benefits associated with it. These may include a decrease in body fat, improvement in blood fats and blood pressure, improvement in physiological function, increased strength, decreased chance of injury and decrease in heart disease.
Release and Indemnification
I, __________________, do hereby intelligently and voluntarily assume the risk of and fully and completely release Schock Fitness, LLC, its owners, successors, employees, contractors, representatives, and agents from all and all manner of actions and causes of action, suits, debts, dues, accounts, bonds, covenants, contract, agreements, judgements, claims and demands whatsoever in law or equity and particularly on account of all damages, known or unknown which have resulted or may in the future develop from any and all claims of any kind whatsoever including but not limited to personal injury, no matter how caused, which I may incur or suffer during my use of the facilities and/ or participation as a member or client, in physical, or personal fitness training, either private or as part of a group or any exercise program at Schock Fitness, LLC or off-site with a Schock Fitness, LLC employee, instructor, contractor or affiliate. I hereby waive any claims, suits, action, or causes of action which may or hereafter shall have against Schock Fitness, LLC, its owners, employees, contractors, officers, directors, representatives, agents or successors from all and all manner of action, causes of action, suits, debts, dues, accounts, bonds, covenants, contract, agreements, judgements, claims and demands, whatsoever and including but not limited to all claims of personal injury, no matter how caused, which I may incur or suffer during my use of the facilities and/ or under participation in physical or personal fitness training, either private or as part of a group or any exercise program at Schock Fitness, LLC or off-site with a Schock Fitness, LLC employee, instructor, contractor or affiliate.
I further agree to indemnify and hold forever harmless Schock Fitness, LLC, its owners, employees, contractors, officers, directors, representatives, and agents against all losses, including reasonable attorneys’ fees and court costs, from any and all claims made against it by any party as a result of my actions, negligent or intentional, which may result in injury or damage to another person, and/ or death at Schock Fitness, LLC or off-site with a Schock Fitness, LLC employee, instructor, contractor or affiliate.
Permission to Use Photograph
I grant to Schock Fitness & the Speeder Kids Running Program, its representatives and employees the right to take photographs of me, my child/ children and my property. I authorize Schock Fitness & the Speeder Kids Running Program, its assigns and transferees to copyright, use and publish the same in print and/or electronically.
I agree that Schock Fitness & the Speeder Kids Running Program may use such photographs of me, my child/ children and property for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.
General Health History Form
Click here to print our General Health form and submit it back to our email.
Be sure to fill this out prior to class and email us!
Speeder Kids Running Club Registration:
By signing below, I acknowledge that I am aware that this program for my child will provide her/him with the opportunity to participate in a variety of exercises and activities. I am aware that my child’s participation in these activities is strictly voluntary, and that I may observe/ participate if I prefer. I am also aware that there are always risks involved with performing exercises and I certify that my child is in good health and do not have any conditions that would be aggravated by exercise. I certify that by choosing to have my daughter/ son participate in these voluntary activities, I accept full responsibility for any unplanned consequences. I agree that in the event of an accident or injury, I will hold harmless Schock Fitness and Rebecca Schock DePasquale.
Please fill out the form below, by filling
out the information below you are agreeing
to the above terms of the waiver.