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About
The Workout
Contact Me
Group Fitness Waiver
Name
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First Name
Last Name
Email
*
Preffered Phone
*
(###)
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How did you hear about 239 FIT, LLC?
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Choose One
Social Media
Online Search
Friend/Family
Advertisement
Other
Emergency Contact
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First Name
Last Name
Relationship to Emergency Contact
*
Emergency Contact Preffered Phone
*
(###)
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ACKNOWLEDGE OF RISK AND WAIVER OF LIABILITY
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I understand that I will be participating in a fitness program through 239FIT, LLC. that will require physical exertion. I neither have physical limitations, nor am I taking any medications or receiving any medical treatment that might make it unsafe for me to participate in the fitness program. I understand that, by signing this statement, I am agreeing to not hold 239FIT, LLC. or any of its employees, owners, agents, or insurers responsible for any bodily injury or property damage that I may suffer as a result of my participation in a fitness program through 239FIT, LLC. whether at Miromar Outlets, at home, or elsewhere. As such, I understand and agree that 239FIT, LLC. its employees, owners, agents, or insurers shall not be liable for any bodily injury or property damage that may result either directly or indirectly from my participation in a fitness program through 239FIT, LLC.
Electronic Signature
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Please type first and last name
Date Signed
*
mm/dd/yyyy
Thank you!