TKHS FITNESS CENTER APPLICATION & WAIVER

 

Last Name:

 

 

First Name:

 

 

TK School Resident?

   

Yes

 

No

 

Membership Type:

 

Adult

 

H.S. Student

 

Senior

 

TK Staff Member

 

Birthdate:

 

 

Address:

 

 

City/State/ZIP:

 

 

Phone #’s:

 

 

Emergency Contact(s):

 

 

Emergency Contact Phone Number(s):

 

 

Other:

 

 

There are inherent risks of injury in physical activities.  I understand that, prior to starting an exercise program or significantly increasing my exercise level, it is important that I consult with a doctor or health care provider.  I also understand that participating in physical activities can cause injury, including and but not limited to sprains, broken bones, torn ligaments, exhaustion, heat strokes, and heart attacks.  I have voluntarily decided to use the fitness center and equipment with the knowledge of the danger involved and hereby accept any and all risks of personal injury and/or property damage.  I, for myself and for my successors and assigns, release and hold harmless TK Schools, its board members, employees, and volunteers from any and all claims, causes of action, demands, rights, damages, liability, costs and expenses, of every kind and description, known and unknown, which I now have or which I have ever had in the past or shall have in the future.

 

Signature: _________________________________________    Date: _______________________

If needed:

Parent/Guardian Signature:________________________________   Date:___________________