Name: the undersigned
Mobile Phone #:
Assumption of Risk, Release of Liability, Video/Photo Release and Indemnity Agreement
RVT CrossFit and Rivet Athletic Club
5035 SE McLoughlin Blvd
READ CAREFULLY – DO NOT SIGN THIS DOCUMENT UNLESS YOU FULLY UNDERSTAND IT
Express Assumption of Risk
I, the undersigned, am aware that there are significant risks involved in any physical training regimen that may result in serious injury, including permanent disability, paralysis or death, which may be caused by my own health problems or lack of conditioning, falls, wrongful acts or negligence on the part of myself, my training partner, or other people around me, or improper use or failure of equipment.
Injury may also result simply from the fact of physical training itself. By its very nature, physical training seeks to have me push beyond my limits in order to produce a physical adaptation by my body. This requires feedback from me to my trainer regarding what is happening with my body. Excessive work can result (in rare cases) in exertional rhabdomyolysis. I will look for signs of excessive soreness, darkened urine, and pain in the kidney areas in the days following a particularly intense workout and, if these symptoms occur, seek appropriate medical treatment.
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 my participation in any activity or class while training with RVT CrossFit, either at Rivet Athletic Club or other locations.
I, the undersigned, represent and warrant that I am in good health, mentally and physically capable of performing physical exercise safely, have no physical or mental impairments or illnesses that will endanger myself or others, and that I will never participate in any RVT CrossFit activities or classes if I am in any way impaired due to alcohol use, drug use, fatigue, stress or other cause. Further, I will abide by all rules issued by RVT CrossFit and Rivet Athletic Club.
I am fully responsible for obtaining clearance of my exercise regimen with my personal doctor on a regular basis and for complying with any restrictions my doctor places on my exercise regimen. If I experience any injury, dizziness or other symptoms while exercising, I will immediately stop exercising and consult my doctor. Further, I will immediately stop using any equipment that appears to be malfunctioning or to be damaged in any way and report the problem to RVT CrossFit. I will not use any piece of equipment which I do not know how to safely operate.
I understand the risks of participating in CrossFit and acknowledge that I am voluntarily participating in CrossFit at my own risk.
Release and Indemnification
In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities available at RVT CrossFit, I, the undersigned hereby release CrossFit, RVT CrossFit, Rivet Athletic Club, and their respective principals, agents, employees, and volunteers (collectively, the “CrossFit Parties”) 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 attributed to the negligent acts or omissions of the Crossfit Parties. This release does not extend to claims for gross negligence, intentional or reckless misconduct, or any other liabilities that Oregon law does not permit to be excluded by agreement. I also agree not to sue or make a claim against the CrossFit Parties for death, injuries, loss, damage or harm that occur during my participation in CrossFit activities or classes or that are related in any way to CrossFit activities or classes.
I recognize that there is risk involved in the types of activities offered by CrossFit and accept financial responsibility for any injury or death of any person(s) and damage to property that may result from my negligent or intentional acts or omissions. I, the undersigned, agree to indemnify and hold harmless the CrossFit Parties from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional acts or omissions, including but not limited to settlement amounts, judgments, and attorneys’ fees incurred at any trial, arbitration or appeal.
I acknowledge that I am releasing the CrossFit Parties from liability, and I understand that signing this agreement obligates me to indemnify the CrossFit Parties for any liability for injury or death of any person, as well as damage to property, caused by my negligent or intentional acts or omissions.
I hereby confer on the CrossFit Parties and their assigns and designates the irrevocable, perpetual and unrestricted right to record my participation in CrossFit classes and activities in and on video recordings, audio recordings, photographs, and/or any other media and to use my name, likeness, voice, photograph, biographical information and/or reputation (collectively, the “Information”) in all forms and media and in all manners, including but not limited to the RVT CrossFit and Rivet CrossFit websites, blogs, and social media networks, and in any other media now known or hereafter developed, in connection with advertising, promotion and trade, as well as for any other lawful purpose.
Further, I consent to the digital compositing or distortion of the photographs and/or recordings, including without restriction any changes or alterations as to color, size, shape, perspective, context, foreground or background. I also consent to the use of any published matter in conjunction with such photographs and recordings. I waive any right to inspect or approve the finished versions.
I understand and agree that I will not receive any compensation for the use of my Information and that the CrossFit Parties and their assigns and designates are not responsible for the unauthorized use of my Information by third parties, including, but not limited to downloading of images and videos from the Internet or social media networks such as YouTube, Facebook or Flickr.
I hereby release and discharge the CrossFit Parties and their assigns and designates from any and all claims and/or demands relating to, arising from or in any way involving the use of my Information, including but not limited to claims for invasion of privacy, violation of the right of publicity and of the right of personality, libel, droit morale or any other personal or property right.
I understand that I am authorizing CrossFit to take photographs and videos of my CrossFit activities and that I will not receive any compensation for their use of those photographs and videos.
I grant permission for any person connected with RVT CrossFit or Rivet Athletic Club to administer any first aid s/he deems necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care and transport to the medical facility deemed appropriate. I will be responsible for the cost of any such treatment and transportation.
This agreement shall be binding upon me, my representatives, heirs, and executors.
If any provision of this Agreement is judicially declared to be invalid, unenforceable or void by a court of competent jurisdiction, such decision shall not have the effect of invalidating or voiding the remainder of this agreement, and the part(s) of this agreement so held to be invalid, unenforceable or void shall be deemed stricken, and this agreement will be reformed to replace such stricken provision with a valid and enforceable provision which comes as close as possible to expressing the intention of the stricken provision. The remainder of this agreement shall have the same force and effect as if such part or parts had never been included.
This Agreement is deemed a contract made in Oregon and it shall be construed and enforced according to the laws of the State of Oregon. Any suit or action instituted by either party to enforce the terms shall be brought in the courts in the State of Oregon. Venue is proper only in Multnomah County in Oregon.
In the event suit or action is instituted to enforce any of the terms of this contract or for its breach, the prevailing party shall be entitled to recover from the other party such sum as the court deems reasonable as attorneys’ fees at arbitration, on trial or on appeal, in addition to all other sums provided by law.
I have read and understood the foregoing Assumption of Risk, Release of Liability, Video/Photo Release and Indemnity Agreement.
I understand that by signing this form I am waiving valuable legal rights. I have signed this agreement freely and without inducement or assurance of any nature and intend this document to be a complete and unconditional release of all liability to the greatest extent allowed by the law.
I acknowledge that I have had the opportunity to obtain independent legal advice concerning the ramifications of signing this document and have either done so or waive the right to do so.
If the participant is under the age of 18, a parent or guardian is required to sign below.
In consideration of the minor child named above being permitted to participate in CrossFit classes and activities, I accept and agree to the full contents of this agreement. I certify that I have the authority to sign on behalf of the minor child and to make decisions for the minor child regarding CrossFit classes and activities.