CrossFit Insanity :: Triib, Inc

CrossFit Insanity Drop In Signup

Select the classes on the calendar you'd like to drop into.

The calendar contains CrossFit Insanity's classes they allow drop-ins to attend. You can select as many classes as you'd wish to attend, and your fee will be adjusted accordingly.

Drop In Fee Details

The following invoice shows what you will be charged as you select classes to drop into.

	Date	Time	Class Information	Tax	Total
Total					$0.00

Please enter your information below to register and pay for your drop-in classes

Your Information

First name

Last name

Gender

Phone

Kiosk PIN

Enter exactly 4 numbers, for future kiosk checkouts

Emergency contact name

Emergency contact phone

How did you hear about us?

Referred By Member

Heard about us other

Birthday - Month

Birthday - Day

Birthday - Year

Address 1

Address 2

City

State

Postal code

Message

CrossFit Insanity Liability Waiver (5575)

ASSUMPTION OF RISK:The Client is aware that weight and/or cardiovascular training and similar physical activities can be a hazardous activity and my pose potentially serious risks of injuries/death to the participants. The Client voluntarily participating in these activities with the knowledge of the danger(s) involved, and hereby agrees to accept any and all risks of injury or death, and verifies such with his/her signature.

RELEASE:As consideration for being permitted by Trainer to participate in these physical activities and to use the facilities of Fitness Rx, LLC dba CrossFit Insanity, located at 17875 Sky Park Circle, Unit #AB, Irvine, CA 92614, I, the Client, hereby agree that I, my assignees, heirs, distributes, guardians, and legal representative(s) will not make a claim against, sue, or attach the property of any Fitness Rx, LLC dba CrossFit Insanity, its employee(s), trainers, independent contractors, or owner, for injury or damage resulting from the negligence or other acts, howsoever caused, by any employee, agent or assistant of Fitness Rx, LLC dba CrossFit Insanity or any of its affiliated organizations as a result of my participation in a weight and/or cardio training program. I, the Client, hereby release Trainer and Fitness Rx, LLC dba CrossFit Insanity from all actions, claims or demands, that I, my assignees, heirs, distributes, guardians, and legal representative(s) now have or may hereafter have for injury or damage resulting from my participation in a weight and/or cardio training program. I, the Client, understand that I am personally responsible for my actions while participating in my assigned weight and/or cardio training program, and I waive responsibility of Trainer and Fitness Rx, LLC dba CrossFit Insanity if I should incur any injury or damage as a result of my own negligence.

LIABILITY WAIVER:The Client expressly agrees that all weight training and/or cardio programs offered by Trainer, shall be undertaken by Client at his or her sole risk. The Client understands and takes full responsibility for any and all injuries/damage(s) as a result of his/her own negligence, the negligence of others, or through no fault of the Client, Trainer, or anyone else, due to the nature of the activity. It is further agreed that Trainer shall not be liable for any injuries or damage to Client or guest, nor be subject to any claim, demand, injury or damages whatsoever, including but not limited to those damages resulting from acts of active or passive negligence on the part of Trainer, his/her successors or assigns.The Client agrees to indemnify and hold Trainer harmless of any loss caused by Client for which Trainer is accused or held liable including attorney’s fees and court costs.

Please answer the following questions

STATEMENT OF HEALTH: I, ______(enter full name)_____________________, the Client, hereby certify that I know of no medical problem (except those noted herein) that would increase my risk of illness and injury as a result of participation in a regular weight and or cardio training program. I understand that I have been advised to consult a physician prior to commencement of my weight and/or cardio training program to ensure my state of wellness to participate in such strenuous activities. Furthermore, I understand my trainer does not hold him/herself out to be a licensed physician.

Please describe any Injuries, Health Conditions, limitations or Drug Allergies you are aware of:

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