: 07932 361759
:
: 07932 361759
:
I the individual {participant}, in consideration of my participation in the activities sponsored, provided by, or affiliated with Bungee Fit {company}, including, but not limited to classes, workshops, lessons, personal training, individual direction, parties and all other uses of company's facilities, fixtures and equipment, whether or not taking place at or upon company's premises {Activities}, hereby acknowledge and agree to the following terms of the this waiver of Liability, Medical Release and Authorisation {Waiver}.
Participant acknowledges that participation in the Activities may include exercises which are physically demanding and may subject the participant to stress, anxiety, and hazardous situations. Participants understand and agrees that the Activities involve an inherent risk of severe personal injury. Participant agrees that he/she, on behalf of participant and participants heirs, executors, administrators, or other personal representatives who may have standing to assert a claim on behalf of participant, hereby expressly, voluntarily and without condition waives, releases and forever discharges company and company's owners, managers, officers, instructors, employees, representatives and agents {Releasees}, from any and all liability for personal injury, death, damage to property or loss of any kind resulting from or arising out of participants participation in the Activities, regardless of the cause of such injury, loss or damage; provided, that such is not the result of or does not arise from the intentional misconduct of company or Releasees. Further, participant assumes full and complete liability and responsibility and shall reimburse company for any damage or injury to others or to company's facilities caused by participant.
Participant represents that he/she is in satisfactory physical condition to participate in the Activities and understands that participation in the Activities is a voluntary decision made by the participant with knowledge of the risks attendant thereto. In lieu of providing a medical release from a doctor authorizing the participation of participant in the Activities, participant hereby represents that he/she has no knowledge of any physical or mental impairments, diseases, or other medical issues which could affect participant’s safe participation in the Activities.
Participant agrees that the company and its owners, managers, employees, instructors, representatives and agents are authorised to act for participant according to their best judgement in any emergency requiring medical attention, including administration of first aid procedures, and participant hereby waives and releases such persons from any and all liability for injuries, illnesses, or losses caused by or arising from said actions. Participant further authorises medical transportation, at participant’s sole expense, to a medical facility or hospital for treatment.
I understand that this is my responsibility to arrive at the venue on time and to leave adequate time for the journey. Bungee Fit cannot accept any liability for information from third party sources; classes start promptly at the times listed by Bungee Fit. For safety reasons, latecomers may not be allowed to join the class.
I agree that any photographs or video taken of me and other participants during the classes may be used for promotional purposes for similar Bungee Fit services in the future. These images and video content will not be shared with third parties for anything other than our own promotion.
I WAIVE, RELEASE, AND DISCHARGE from any all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity. The following entities or persons; Bungee Fit, Nikkie-Jays Bungee Fit, Nikkie Smith, Unit 21c, 21-25 Sedgley Street, Wolverhampton, WV2 3AJ.
I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.
Signed __________________________________________________
Print {name}_____________________________________________
Date ______________________________________________________
Please read our full terms and conditions before signing up. These are intended to make sure that you are aware of the potential risks involved in taking part in a Bungee Fit class and to encourage you to minimise the risk of injury to yourself and any other participants. If there is anything you're not sure about, please don't hesitate to contact us. Potential risks of injury are limited throughout the activity through supervision and guidance from a trained professional.
Please answer the following health screening questions before taking part in a Bungee Fit class. Have you ever had or do you currently have...........
1. Recurrent back problems or surgery? YES or No
2. Any wrist, elbow, shoulder or arm problems or surgery? YES or NO
3. Any ankle, knee or leg problems or surgery? YES or NO
4. Asthma or any breathing difficulties? YES or NO
5. Blood pressure problems? YES or NO
6. Heart problems of any kind? YES or NO
7. Epilepsy, seizures, convulsions or medications to prevent them? YES or NO
8. Diabetes YES or NO
9. Do you regularly take prescription or non-prescription medications {excluding birth control} YES or NO
10. Women; Are you pregnant? YES or NO
11. Any other medical conditions that you think we should be aware of? YES or NO
If you have answered YES to any of the above, please contact us with more details before booking to ensure that you are able to participate. Any information you share with us will be kept in complete confidence. Thank you.
Signed___________________________________
Print _____________________________________
Date:______________________________________
Call today on 07932 361 759 to book a lesson for bungee fit in Wolverhampton.