CrossFit Mount Kisco (Itwaru Corp.) Waiver & Health Info
25 Hubbels Drive Mount Kisco, NY 10549
Participants involved in any activities offered by CrossFit Mount Kisco may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the CrossFit Mount Kisco website, social media, or in any editorial, promotional or advertising material produced and/or published by CrossFit Mount Kisco.
Waiver and Release of Liability
Express Assumption of Risk: I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; injury or death due to a medical condition, whether known or unknown by me; and/or strains and sprains. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of CrossFit Mount Kisco. I acknowledge that I have no physical impairments, injuries, health conditions or illnesses that will endanger me or others, or would increase my risk of illness or injury as a result of participation in a fitness program designed by CrossFit Mount Kisco.
Release of Liability: In consideration of CrossFit Mount Kisco allowing me to participate in activities offered by CrossFit Mount Kisco, and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by CrossFit Mount Kisco, I, the undersigned hereby release CrossFit Mount Kisco, Itwaru Corp., and their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with CrossFit Mount Kisco/Itwaru Corp. to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child.
Indemnification: The participant recognizes that there is risk involved in the types of activities offered by CrossFit Mount Kisco. Therefore the participant accepts financial responsibility for any injury that the participant may cause either to himself or herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless CrossFit Mount Kisco, Itwaru Corp., and their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by CrossFit Mount Kisco. This includes but is not limited to activities offered at its main facility, parks, recreational areas, playgrounds, areas adjacent to main facility, and/or any area selected for training by CrossFit Mount Kisco.
This agreement contains the entire agreement between the CrossFit Mount Kisco, Itwaru Corp. and the undersigned, and supersedes any prior written or oral agreements between them concerning the subject matter of this agreement. The provisions of this may be waived, altered, amended or repealed, in whole or in part, only upon prior written consent of CrossFit Mount Kisco.
I have fully read and fully understand the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify CrossFit Mount Kisco, Itwaru Corp., and their principals, agents, employees and volunteers for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.
Please answer the following questions