2009 Go Training- Spring Strength Sessions

Name:_______________________________________________

Address:_____________________________________________

City, Zip_____________________________________________

Phone_______________________________________________

Email (REQUIRED)____________________________________

Emergency Contact with phone___________________________

Health issues that could affect your training_________________
____________________________________________________
____________________________________________________

 Cost:  $125  - checks to Go! Training

  note – this  does not include Los Campeones membership which is $35 per month.  Los Campeones membership needs to be paid at your first session remember to bring your check book.

         

 PAYMENT INSTRUCTIONS:                      Go! Training

Please make checks out to:                                 4845 Emerson Ave S.

                                                                          Minneapolis, MN 55419

 

WAIVER AND RELEASE OF LIABILITY 

Identification of Risk.  I, _________________________________, know that physical training for cross country skiing, running, biking, general fitness or strength involves risk of injury or property damage, which includes serious injury, including permanent disability and death.  I understand that these injuries might result not only from my actions, but the actions, inactions, or negligence of others.

 

Assumption of Risk.  I agree that I am responsible for my health and safety while training for and participating in cross country skiing, running, biking ,general fitness and strength training, including any other sports or exercises I may participate in to further my training.  I assume all risks, both known and unknown, connected with my participation.  I understand that any physical training program should only be undertaken after a full examination by, and receipt of permission from, my doctor.

Waiver.  Being aware of the risks and willing to assume them, I waive, release, and hold Go!Training, Piotr Bednarski, and owners/lessors of used premises from all claims for liability, injury, loss, wrongful death or property damage connected with my training plan and program and the exercises and sports that I undertake in order to further my training.  I intend for this waiver and release to also apply to my relatives, personal representatives, heirs, beneficiaries, next of kin, and assigns.

Insurance.  I currently have, and agree to maintain throughout the time I participate, sufficient medical and accident insurance.  I understand that this is my responsibility and release any one else from providing it for me.

I have read this agreement and waiver carefully, understand that I give up substantial rights by signing it, and sign it voluntarily.

________________________________________________________Date____________________

Participant’s signature

For participants under age 18:

I consent to the above person’s participation in training for cross country skiing, running, biking or general fitness and strength.  I acknowledge that I assume all risks, known and unknown, and waive all claims in advance.

________________________________________________________Date______________________

Parent/guardian’s signature