COHORT WAIVERS

Has your doctor ever told you that you have a heart condition or have ever suffered a stroke? Do you ever experienced unexplained pains in your chest at rest or during physical activity/exercise? Do you ever feel faint or have spells of dizziness during physical activity/exercise that causes you to lose balance? Have you had an asthma attack requiring immediate medical attention any time over the last 12 months? If you have diabetes (type I or type II) have you had trouble controlling your blood glucose in the last 3 months? Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise? If yes, please provide more information in the box below. Do you have any medical condition(s) or injuries that may make it dangerous for you to participate in physical activity/exercise? If yes, please provide more information in the box below. Please read Carefully AND SIGN THE STATEMENT BELOW  Ask any coach to guide you in to the most suitable class or scaled workout.  Work at a low intensity on your first few sessions and concentrate on learning to do the exercises with correct technique before increasing intensity. STATEMENT I recognise that Cohort CrossFit staff are not able to provide medical advice in regard to my fitness and that this information is used only as a guideline to determine the limitations of my ability to exercise. The information is used to assist in the exercise prescription process and to prescribe an appropriate level of exercise suited to my specific needs. I have answered the questions to the best of my ability and understand the advice above. I warrant that my doctor has approved me to take part in physical activity. I will notify Cohort CrossFit staff of any future changes to the information provided above.

Please fill out below Waiver.

Personal Waiver *
Personal Waiver
Waiver, release and informed consent for exercise for use of Cohort CrossFit (Central Coast Strength And Conditioning Pty Ltd (ABN 100-105-475)) (“Cohort CrossFit”) Gyms. I hereby request permission to use the Cohort CrossFit gym at Unit 3/217 The Entrance Road Erina, including use of the equipment and facilities contained therein, participation in training and exercise programs conducted by Cohort CrossFit, be they on the gym premises or external, and to undertake athletic activity which may include but is not limited to personal training, fitness classes, athletic competitions, power lifting and gymnastics (collectively referred to in this agreement as the “Gym”). I understand that this agreement is a binding contract and that Cohort CrossFit are permitting me the use of the Gym in consideration of, amongst other things, signing this agreement and agreeing to its terms and conditions. Use of the Gym is limited to persons who are at least 14 years of age (unless written medical clearance is given). All users of the Gym who are less than 16 years of age must be supervised by an adult when using the Gym. If under the age of 16 years, a parent or guardian must complete and sign this document on the user’s behalf. If the user is under 18 years old, Cohort CrossFit may specify certain programs, classes and activities where adult supervision is required. Warning: Cohort CrossFit gives you warning that, whilst using the Gym you may suffer injuries including broken bones, soft tissue injuries, joint injuries, spinal injuries, heart attack, stroke and rhabdomyolysis. These injuries may occur as a result of, amongst other things, you slipping on wet flooring, weights striking you, collision with equipment or with other users. Release and Indemnity: In consideration of Cohort CrossFit permitting you to use the Gym you agree that Cohort CrossFit or its owners, volunteers, directors, officers, employees, trainers, instructors, agents, officials, independent contractors, servants, representatives, successors and assigns shall not be liable for any loss, damage or theft of any property belonging to you, or brought on to the Gym premises by you or your guests. Cohort CrossFit shall not be liable for any death, injury, loss or damage of any kind suffered by any person whilst using the Gym, participating in or watching activities on the Gym premises, caused in any manner whatsoever, including, but no limited to, the negligence of Cohort CrossFit. If this agreement is being signed by a parent or guardian on behalf of a minor child, then the parent or guardian assumes full responsibility for and provides this release on behalf of that minor child. Further Acknowledgments and Agreement: I acknowledge that I will comply with any reasonable direction of the officials and staff of Cohort CrossFit in relation to: entry and exit to and from the Gym; the use of the facilities and equipment in the Gym; my behaviour and conduct whilst on the Gym premises. I agree that I am in a good state of health and I am medically fit to use the Gym and there is no medical reason to prevent me from proceed- ing with the use of the Gym without endangering my health. I acknowledge that I have completed a health questionnaire and provided the completed questionnaire to Cohort CrossFit. I accept that any training program developed or recommended use of equipment by Cohort CrossFit has been developed in good faith relying (among other things) on the information provided in that health questionnaire. This agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity. This agreement and any rights, duties and obligations as between the parties to this agreement shall be governed by and interpreted solely in accordance with the laws of New South Wales, Australia and no other jurisdiction. Any litigation involving the parties to this agreement shall be brought solely within New South Wales and shall be within the exclusive juris- diction of the courts of New South Wales. In entering into this agreement I am not relying on any oral or written representation or statements made by Cohort CrossFit with respect to the safety of athletic activities, the suitability of any program developed by Cohort CrossFit, the use of any equipment or facilities in the Gym, other than what is specifically set out in this agreement. The Warning, The Release and Indemnity and the Further Acknowledgments and Agreements is ongoing and will apply to each and every occasion I use the Gym. If any provision of this agreement is prohibited by law or judged by a court to be unlawful, void or unenforceable, the provision shall, to the extent required, be severed from this agreement and rendered ineffective as far as possible without modifying the remaining provisions of this agreement, and shall not in any way affect any other circumstances of or the validity or enforcement of this agreement.