Informed Consent and Waiver for use of Equipment and Facilities


hereby consent and request to participate in membership and use of the equipment, programs and facilities of The Wellness Center.

I understand that the use of facilities and equipment at The Wellness Center carries inherent risks of injuries, disabilities or death. Therefore, I agree to assume full responsibility and risk, during and after my participation, for my use of the equipment and facilities at The Wellness Center. I have been advised, understand, and acknowledge that no guarantees have been or shall be made with regard to the safety of any facility or equipment at The Wellness Center.

I understand that the use of exercise equipment and facilities as part of any program at The Wellness Center may subject me to certain physical and medical risks that I agree to assume. I also understand that The Wellness Center staff recommends that I consult a physician before using the equipment and facilities or beginning any exercise program. Exercise, even when done correctly, can cause physical injury. It is my responsibility to seek medical advice before using the equipment or facilities or beginning to participate in this program.

If I choose not to seek advice from my physician, I declare myself to be physically sound and suffering no physical impairment, condition, or illness which would prevent my safe participation in this program.

Notwithstanding that which is stated above, I have been advised that I have the opportunity to undergo an evaluation and assessment which includes the completion of questionnaires addressing various health matters, my current lifestyle, and other relevant matters. I have been advised and understand that this information should be shared with my physician prior to commencing use of The Wellness Center for an exercise program.

I understand that The Wellness Center assumes no responsibility for my personal safety while I am participating in The Wellness Center activities, and also understand that I may not always be supervised in The Wellness Center activities by licensed, certified, or registered instructors or professionals. I understand that The Wellness Center makes no claim to offer assessment or medical treatment of any mental or physical disease or condition and that The Wellness Center may not always monitor the appropriateness of the activities in which I choose to participate.

I hereby release The Wellness Center, its officers, directors, agents, management firm and employees from any and all liability which may arise directly or indirectly from any damage to my person or property as a result of my participation in the chosen program and my use of The Wellness Center's facilities. In the event that I suffer any medical problem during or resulting from my participation in this program, I acknowledge that I shall be solely responsible for seeking and obtaining appropriate medical treatment at my sole cost and expense.

I acknowledge that I have read this entire document and fully understand its contents. I also acknowledge that any questions or concerns I may have about this program have been answered to my satisfaction at this time and that I should consult with an appropriate medical professional if I have further questions or concerns regarding my participation in this program at The Wellness Center.

Parent / Guardian Consent for Minor's participation
as the parent/legal guardian of:
I hereby authorize his/her participation in exercise at The Wellness Center. I acknowledge that I have read this entire document, understand its' contents, and agree to abide by its terms and conditions as related to the participant named above.