I acknowledge that I have chosen to participate in one or more physical fitness program(s)/class(es) provided by Verve Health & Fitness and CrossFit Rosslyn (hereinafter “VERVE/CFR”) which may include, but not necessarily be limited to CrossFit Training and/or individual training or coaching of any kind. VERVE/CFR has made me fully aware that the fitness programs/classes which VERVE/CFR offers and in which I desire to participate are of a nature and kind 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 these 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 VERVE/CFR 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 VERVE/CFR. VERVE/CFR informed me that there exists the possibility of adverse physical changes during an exercise program, and I fully understand the same, VERVE/CFR informed me that these changes could include, but are not limited to, 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 fully understanding of the above information, I agree to assume any and all risk associated with my participation in VERVE/CFR fitness 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 VERVE/CFR, and with my full understanding of all of the above, I voluntarily waive, release, discharge, and hold harmless VERVE/CFR 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 VERVE/CFR fitness programs/classes, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties . In signing this document, I fully recognize and understand that if I (or any minor on whose behalf I am signing this release) am hurt, die, or my property is damaged, I am giving up my right to make a claim or file a lawsuit against VERVE/CFR, even if they negligently or by some other act or omission cause the injury or damage. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement if held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect.

Indemnification: I recognize that there is risk involved in the types of activities offered by VERVE/CFR. 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 defense costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify, defend, and hold harmless VERVE/CFR, 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 my negligent or intentional act or omission while participating in activities offered by VERVE/CFR .

Use of picture(s)/film/likeness: I further agree to allow VERVE/CFR its agents, officers, principals, employees and volunteers the use of a 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 VERVE/CFR of this in writing.

As a parent or legal guardian of a VERVE/CFR participant under 18 years of age, I have read and voluntarily agree that said minor may participate in these fitness programs/classes, and I sign this release on their behalf and on the behalf of the minor’s parents and legal guardians. In addition, I also give full permission for any person connected with VERVE/CFR to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call 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. A minor must abide by VERVE/CFR rules and procedures as attached.


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