Gym Health Waiver

In order to enter the gym, we must have a health waiver on file.

First name

Email Address

Last name

Date of Birth

I will conduct myself in a controlled and reasonable manner at all times and will refrain from using any equipment in a manner inconsistent with its intended design & purpose.

I agree

I disagree

I acknowledge that I am physically fit & mentally capable of performing the physical activity I choose to participate in.

I agree

I disagree

I and behalf of my heirs, hereby release indemnify & hold harmless Bungee Boogie Fitness, its officers & owner of premises to conduct the event from any & all claims arising out of or related to any injury, disability or death I may suffer, loss, or damage to person or property. Whether arising from negligence of the releases or otherwise, to the fullest extent permitted by law.

I agree

I disagree

By signing below, I hereby grant & convey Bungee Boogie Fitness all rights, title, and interest in recording my name, image, voice, or statements including any & all photographic images.

I agree

I disagree

I declare that the info I’ve provided is accurate & complete

Your Signature

Today's Date

Thanks for submitting! Your response has been recorded.