Non Member 5 pack Personal Training 60 min (Platinum Package)

$305

with Staff: Bill Bacarella
Personal Training

Your Information


Enter exactly 4 numbers, for future kiosk checkouts
Light the Fire CrossFit Liability Waiver (4241)
INFORMED CONSENT/ASSUMPTION OF RISK
I agree to participate in one or more physical fitness program(s) class(es) sponsored by Light the Fire Fitness, LLC., which may include, but not necessarily be limited to, Light the Fire Boot Camp, Cross Fit Training, and/or training of any kind by any affiliate, subsidiary or partnership of Light the Fire Fitness, LLC and/or William Bacarella (hereinafter collectively referred to as Light the Fire (Crossfit).  Lightthe Fire Crossfit made me fully aware that the fitness programs/classes which Light the Fire Crossfit offers and in which I desire to participate are of a nature and mind that are extremely strenuous and can/may push me to the limits of my physical abilities.  I the undersigned recognize and understand that the programs/classes are not without varying degrees of risk which may include, but are not limited to the following:  Injury to the musculoskeletal and/or cardio respiratory systems 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, or injury or death due to a medical condition, whether known or unknown by me.  I am aware that any of the above mentioned risks may result in serious injury or death to myself and/or my partner(s).

I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in Light the Fire Crossfit programs/classes and accept full responsibility for any injury or death that may result from participation in any activity, class or physical fitness program.  I hereby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by Light the Fire Crossfit.  Light the FIre Crossfit informed me that there exists the possibility of adverse physical changes during an exercise program, and I fully understand the same.Light the Fire Crossfit informed me that these changes could include abnormal blood pressure, fainting, disorder of heart rhythm, stroke, and in very rare instances, heart attack or even death, and I fully understand the same.  With my full understanding of the above information, I agree to assume any and all risk associated with my participation in Light the Fire Crossfit programs/classes.

Release:
In full consideration of the above mentioned risks and hazards and in full consideration of the fact that I am willingly and voluntarily participating in the activities made available by Light the Fire Crossfit, and with my full understanding of all of the above, I hereby waive, release, remise and discharge Light the Fire Crossfit and its agents, officers, principals and employees and volunteers of any and all liability, claims, demands, actions or rights of action, or damages of any kind related to, arising from, or in any way connected with my participation in Light the Fire Crossfit programs/classes, 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 Light the Fire Crossfit 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, 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:
I recognize that there is risk involved in the types of activities offered by Light the Fire Crossfit.  Therefore I accept financial responsibility for any injury that I or the participant may cause either to him/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 Light the Fire Crossfit, 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 negligent or intentional act or omission while participating in activities offered by Light the Fire CrossFit.

Use of picture(s)/film/likeness:I agree to allow Light the Fire Crossfit, its agents, officers, principals, employees and volunteers the picture(s), film and/or likeness of me for advertising purposes.  In the event I choose not to allow the use of the same for said purpose, I agree that I must inform Light the Fire Crossfit of this in writing.

Member understand and acknowledges that he/she will, as a result of his/her membership in Light the Fire Crossfit, have significant contacts with other members, employees of Light the Fire Crossfit, as well as other persons and entities which have been a contractual relationship with Light the Fire Crossfit, and shall become familiar with trade secrets, methods of doing business, and other confidential business and proprietary information of Light the Fire Crossfit that does not qualify as a trade secret.   Therefore, during the term of this membership and for a period of two years following the termination of membership, Member will not, individually or in conjunction with others, directly or indirectly, engage, or assist in any manner others in engaging, in any part of any business which competes directly or indirectly with Light the Fire Crossfit, whether as an officer, director, proprietor, employer, partner, independent contractor, employee, or shareholder, without Light the Fire Crossfit’s prior written consent, which may be withheld in its sole discretion.  The provision of this Paragraph shall continue in full force and effect even after the termination of Member’s membership in Light the Fire CrossFit.

Member understands and acknowledges that if he/she needs to cancel or put their membership on hold, they must fill out the cancellation/hold form at Light the Fire CrossFit.  The form must be completed 2 weeks in advance of the 1st of the month they wish to stop payment, and signed by Coach Bill Bacarella for approval.  If the above process is not followed, the member will be charged for the month.  Phone calls, text messages are not suitable forms of cancellations/hold of an account and will not be authorized.

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 the parties named 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.

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