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Portland - SoPo - Brunswick, ME
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Waiver
Gym & Fitness Liability Waiver
First name
Last name
Email
Are you cleared to participate in physical activity?
No
Yes
Do you have any pre-existing medical condtions, restrictions or injuries that we should know about?
Are you 18 years or older?
No
Yes
Initials (Parent/Guardian if not 18 years old)
I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
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