CJs Functional Fitness & Self Defense LLC & K-Flash Kustom Fitness

Liability Waiver
15711 Condon Ave. Suite A-6, Lawndale, Ca. 90260
TERMS AND CONDITIONS:
1. I am aware that CJs Functional Fitness and Self-Defense, K-Flash Kustom Fitness LLC, and
instructors are not medical doctors and are not qualified to determine a participant's physical
capability to engage in strenuous exercise.
2. The information given on my medical history questionnaire is correct to the best of my
knowledge. I understand that absence of the physical problems listed on this form does not
necessarily guarantee that I am in satisfactory health to participate in CJs Functional Fitness
and Self-Defense LLC activities, and K-Flash Kustom Fitness LLC.
3. I have or will agree to obtain physician approval of this health and wellness program prior to
my participation in an exercise program offered by CJs Functional Fitness and Self-Defense
LLC, and K-Flash Kustom Fitness LLC.
4. I agree to allow CJs Functional Fitness and Self-Defense LLC, K-Flash Kustom Fitness, and
trainers to consult my physician for written approval to participate in an exercise program. If
my condition or medication changes, I will inform the fitness trainer.
5. WAIVER AND RELEASE OF LIABILITY: (Read carefully before signing!)
I UNDERSTAND AND ACKNOWLEDGE THAT THERE ARE RISKS INVOLVED IN BEING
IN AND AROUND CJs Functional Fitness and Self-Defense LLC, and K-Flash Kustom
Fitness LLC Gamble FACILITIES, INCLUDING BUT NOT LIMITED TO THE RISKS
INVOLVED IN UTILIZING EQUIPMENT OR PARTICIPATING IN ANY EXERCISE OR
FITNESS ACTIVITY. IN CONSIDERATION FOR BEING ALLOWED TO UTILIZE CJs
Functional Fitness LLC & K-Flash Kustom Fitness LLC FACILITIES, I AGREE THAT I
WILL ASSUME THE RISK AND FULL RESPONSIBILITY FOR DETERMINING THE NEED
FOR MEDICAL CLEARANCE FROM MY PHYSICIAN AND OBTAINING SUCH
CLEARANCE, THE SAFETY AND/OR EFFICACY OF ANY EXERCISE PROGRAM I AM
INVOLVED IN, AND ANY AND ALL INJURIES, LOSSES, OR DAMAGES, WHICH MIGHT
OCCUR TO ME AND/OR TO MY FAMILY WHILE ON THE PREMISES OF CJs Functional
Fitness and Self-Defense LLC and K-Flash Kustom Fitness LLC TO THE MAXIMUM
EXTENT ALLOWED BY LAW. I AGREE TO WAIVE AND RELEASE ANY AND ALL
CLAIMS, SUITS, OR RELATED CAUSES OF ACTION AGAINST CJs Functional Fitness
and Self-Defense LLC, K-Flash Kustom Fitness LLC, AND THEIR OWNERS, OFFICERS,
EMPLOYEES, FITNESS INSTRUCTORS, VOLUNTEERS OR AGENTS OR AFFILIATES
FOR INJURY, LOSS, DEATH, COSTS OR OTHER DAMAGES TO ME, MY HEIRS OR
ASSIGNS, WHILE ON THE PREMISES OF, OR WHILE TRAVELING TO OR FROM CJs
Functional Fitness and Self-Defense LLC, and K-Flash Kustom Fitness LLC.
I FURTHER AGREE THAT I WILL INDEMNIFY AND HOLD CJs Functional Fitness and
Self-Defense LLC and K-Flash Kustom Fitness LLC, TO THE MAXIMUM EXTENT
ALLOWED BY LAW, FROM INJURY, LOSS, DEATH, COSTS, OR OTHER DAMAGES TO
ME, MY HEIRS OR ASSIGNS, OR THIRD PARTIES FOR CLAIMS, SUITS, OR RELATED
CAUSES OF ACTION ASSERTED AGAINST A CJs Functional Fitness and Self-Defense
LLC, and K-Flash Kustom Fitness LLC RISING FROM MY CONDUCT AND/OR MY
FAMILYS CONDUCT WHILE ON THE PREMISES OF, OR WHILE TRAVELING TO OR
FROM, IFURTHER AGREE TO RELEASE, INDEMNIFY AND HOLD CJs Functional
Fitness and Self-Defense LLC, and K-Flash Kustom Fitness LLC FROM ANY LIABILITY
WHATSOEVER FOR FUTURE CLAIMS PRESENTED BY MY CHILDREN FOR ANY
INJURIES,
LOSSES
OR
DAMAGES.
I have read this waiver and release of liability. ______ Initials__

By my Signature below, I understand and agree to this agreement.

Print Name____________________ Signature__________________ Date_________
Guardian (if under 18)_______________________
Emergency Contact__________________ Phone _____________________

CJs Functional Fitness & Self Defense LLC & K-Flash Kustom Fitness
Liability Waiver
15711 Condon Ave. Suite A-6, Lawndale, Ca. 90260

Print Name____________________ Signature__________________ Date_________

Guardian (if under 18)_______________________
Emergency Contact__________________ Phone _____________________