Jackie Swartz Fitness, LLC
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Fitness Programs
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12 Week Transformation
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Schedule Jackie
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New Clients
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New Client Questionnaire
Liability Waiver
About Jackie
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Fitness and Nutrition by Jackie Swartz
Liability Waiver
Home
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Fitness Programs
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12 Week Transformation
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Meal Prep
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Schedule Jackie
/
New Clients
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New Client Questionnaire
Liability Waiver
About Jackie
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Printable PDF Version
Liability Waiver
Name
*
First Name
Last Name
Please Read and Acknowledge
*
Jackie Swartz Fitness, LLC Waiver, Release of Liability, and Assumption of Risk I, the undersigned, am employing the services of Jackie Swartz Fitness, LLC, so that I can obtain information, guidance, coaching and/or training, as the case may be, related to diet and nutrition (“Nutritional Guidance”), and/or fitness activities, which may include, but are not limited to, aerobic exercises, strength and/or resistance training, and/or stability balance exercises (collectively, the “Activities, and individually, the “Activity”). I understand and am aware that any exercise program, whether or not requiring the use of exercise equipment, is a potentially hazardous activity. I also understand and am aware that any exercise and/or fitness activities involve a risk of injury, which may include abnormal changes in blood pressure, fainting, risk of heart attack or stroke, respiratory distress, joint pain, bone injury, and other serious disability or possible death (collectively, the “Potential Risks and Dangers”), and that I am voluntarily participating in the Activities and the use of equipment and machinery, whether on the premises of Jackie Swartz Fitness, LLC or elsewhere, with the full understanding and appreciation of the Potential Risks and Dangers. I agree to assume and accept the Potential Risks and Dangers associated with any and all Activities and/or Nutritional Guidance in which I participate whether on the premises of Jackie Swartz Fitness, LLC or elsewhere. I understand that I will be working with a Nutrition Educator and qualified Personal Trainer that does not dispense medical advice nor prescribe medical treatment. I also understand that any consultation and/or other services provided by Jackie Swartz Fitness, LLC does not replace the necessary services of a licensed physician and does not constitute a medical service or healthcare treatment. I understand that any nutritional and/or physical evaluation or test provided to me is not intended for the diagnosis of disease, but rather is intended to be a guide in developing an appropriate health-supportive program for me, and to monitor my progress in achieving my personal nutritional and/or fitness goals. I also understand that any recommendations made to me will be explained and that I will have the opportunity to ask questions of those involved in my care, and that any exercise and/or Activities performed, whether on the premises of Jackie Swartz Fitness, LLC or elsewhere, will be entirely at my own risk. I understand that the potential benefit of the Nutritional Guidance and/or Activities may include decreased body fat, improved cholesterol levels, improved blood pressure, increased muscle strength and endurance, decreased risk of heart disease, and improved psychological function. I also understand that the benefits experienced may vary and directly relate, among other factors, to prescribed intensity, duration, frequency, progression, and types of Activity, as well as my dedication thereto. I have read the above information and understand the Potential Risks and Dangers of working with Jackie Swartz Fitness, LLC, and the use of its premises and equipment, and acknowledge that as a condition to engaging services of Jackie Swartz Fitness, LLC, I agree (i) to ASSUME ANY AND ALL POTENTIAL RISKS AND DANGERS REGARDLESS OF SEVERITY OR DEATH, (ii) to WAIVE, RELEASE, AND NOT SUE, MAKE ANY CLAIMS OR FILE ANY ACTIONS against Jackie Swartz Fitness, LLC, its owners, affiliates, officers, agents, employees, volunteers, contractors, successors and assigns (collectively, the “Indemnified Parties”, and individually, the “Indemnified Party”), that are based on, arise or result from, in whole or part, participation in the Nutritional Guidance and/or any Activity whether on the premises of Jackie Swartz Fitness, LLC or elsewhere, and (iii) to INDEMNIFY, DEFEND, AND HOLD THE INDEMNIFIED PARTIES HARMLESS from any and all claims, demands, actions, causes of action, losses or liabilities whatsoever arising from or related to participation in the Nutritional Guidance 2 and/or any Activity whether on the premises of Jackie Swartz Fitness, LLC or elsewhere, and any loss, damage, or injury or death, that I may sustain or cause to be sustained to others or their property. I agree to pay all costs, including reasonable attorney’s fees and disbursements, incurred by any Indemnified Party in defending an investigation, claim or suit brought by or on my behalf. I authorize Jackie Swartz Fitness, LLC and/or its authorized personnel to call for medical care, treatment, and/or procedures, or to transport me to a medical facility or hospital if, in the opinion of such personnel, medical attention is needed. I authorize Jackie Swartz Fitness, LLC and/or its authorized personnel to take and use photographs, video recordings, or movies of me that are taken during an Activity or Nutritional Guidance consultation, and to use and sublicense such material for any purpose in promoting Jackie Swartz Fitness, LLC. I agree that ALL claims arising from or related to any Nutritional Guidance, Activity, or use of the premises and equipment of Jackie Swartz Fitness, LLC, including for injury to person or property and/or death shall be GOVERNED BY COLORADO LAW, without regard to choice of law or conflict of law principles, and that EXCLUSIVE JURISDICTION shall be in the District Court residing where the alleged incident occurred or in Federal Court for the District of Colorado. I VOLUNTARILY AND IRREVOCABLY WAIVE ANY OBJECTION TO SUCH LAW AND JURISDICTION. I acknowledge that this Agreement shall be binding to the fullest extent permitted by law. If any provision of this Agreement is found to be unenforceable, the unaffected terms shall be enforceable and remain in full force and effect. This Agreement shall be binding upon my assignees, subrogors, distributors, heirs, next of kin, executors, and personal representatives.
I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS AGREEMENT IN ITS ENTIRETY, THAT I FULLY UNDERSTAND ITS CONTENTS, AND THAT I AM SIGNING IT WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE. BY SIGNING THIS DOCUMENT I ACKNOWLEDGE THAT I AM OVER THE AGE OF 18, OR AM THE PARENT OR LEGAL GUARDIAN OF A MINOR UNDER THE AGE OF 18 FOR WHOM I AM ENTITLED TO SIGN ON THEIR BEHALF AND THAT SAID MINOR WILL BE BOUND BY ALL OF THE TERMS UNDER THIS AGREEMENT.
Thank you!
Home
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Fitness Programs
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12 Week Transformation
/
Meal Prep
/
Schedule Jackie
/
New Clients
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New Client Questionnaire
Liability Waiver
About Jackie
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Jackie Swartz Fitness, LLC