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Agreement and Release of Liability and Informed Consent
- In consideration of gaining membership or being allowed to participate in the activities and programs at Bird Dog Pilates & Fitness, LLC and to use its facilities, equipment and machinery in addition to the payment of any fee or charge, I do hereby waive, release and forever discharge Bird Dog Pilates & Fitness, LLC and its owners, officers, employees, affiliates, and representatives, and all others from any and all participation in any activities or my use of equipment or machinery in the above-mentioned facilities or arising out of my participation in any activities at said facility. I do hereby release all of those mentioned an any others acting upon their behalf from any responsibility of liability for any injury or damage to myself, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my participation in any activities of Bird Dog Pilates & Fitness, LLC.
- I understand and am aware that strength, flexibility, and aerobic exercise, including the use of equipment, is a potentially hazardous activity. I also understand that fitness activities involve a risk of injury and even death and that I am voluntarily participating in these dangers involved. I hereby agree to expressly assume all risks of injury and death.
- I do hereby further declare myself to be physically sound and suffering from no condition, impairment disease, infirmity, or other illness that would prevent my participation in any of the activities and programs or use of equipment or machinery except as hereinafter stated. I do hereby acknowledge that it has been recommended that I have a yearly or more frequent physical examination and consultation with my physician as to physical action concerning these fitness activities and equipment use. I acknowledge that I have permission to participate, or that I have decided to participate in activity and/or use of equipment and machinery without the approval of my physician and do hereby assume all responsibility for my participation and activities, and utilization of equipment in my activities.
- Explanation of the session – The exercise session you will become involved in will follow progressive exercise levels and will be regulated by your personal trainer and/or Pilates teacher. The session may consist of aerobic type of activities (rhythmical exercises which utilize large muscle groups for sustained periods of time) such as jogging, cycling, flexibility training, strength training, and/or activities emphasizing proper breathing, and correct spinal and pelvic alignment as well as other similar activities. These exercise activities are designed to place a gradual workload on the body and thereby improve its functioning although no guarantee of improvement can be made. During the exercise session you may experience local muscular soreness and slight fatigue. These minor discomforts may appear in the early stages of the program. However, as the conditioning process continues with regular attendance in the exercise sessions, they should disappear.
- Risks and discomforts of the exercise sessions – The reaction of the cardiovascular system to such activities cannot always be predicted with complete accuracy. Therefore, there is the risk of certain changes occurring during or following the exercises. These changes include abnormalities of blood pressure, heart rate, and in rare instances, cardiac complication. A physician will not be present and symptoms of adverse reactions or responses to exercise will be provided before participating in the exercise session. Should you observe any adverse signs, they should be reported and appropriate modifications in the exercise regimen will take place. Every effort will be made to avoid any adverse reactions by the entrance interview, the health/medical questionnaire and by the observations during the exercise session.
- Confidentiality – The information based on the observations made during the exercise sessions is treated as privileged and confidential. However, it may be used for statistical or scientific purpose with your right to privacy retained.
- Inquiries – You may refuse to participate now or stop at any time during the exercise session. It is your decision. Before signing this form, please feel free to ask any questions regarding any aspect of this program that may be unclear to you. Take as much time as you necessary to think it over and if you wish, you may discuss your participation with your doctor.
I have read the above and do consent to participate in private or semi-private training.