Waiver for Fitness Services - Template, Sample Form Pro · AU-law
✓ Valid in Australia · drafted to comply with local law
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** IMPORTANT **
MESSAGE TO THE DOCUMENT CREATOR:
This document deals with a complex area of law (including the Australian Consumer Law and applicable State and Territory civil liability legislation) and involves serious legal risks.
It is possible that this document will not adequately address your particular circumstances.
This document is provided as a guide only and should always be reviewed by an Australian legal practitioner before use.
This page may be removed before using this document with customers or participants.
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WAIVER, RELEASE, RISK WARNING AND ACKNOWLEDGEMENT OF RISK
(Recreational Services — Fitness Activity)
________ (ABN ________) (hereinafter the "Provider")
of ________
PARTICIPANT DETAILS (hereinafter the "Participant"):
Participant Name: ________
Date of Birth: ________
Participant Address:
________
Contact Telephone: ________
Email: ________
Emergency Contact (name & telephone): ________
THIS WAIVER (hereinafter the "Waiver") relates to the Participant's participation in the following activity (hereinafter the "Fitness Activity"): ________
The Fitness Activity is provided by the Provider at the following premises: ________
IN CONSIDERATION of the Provider permitting the Participant to take part in the Fitness Activity, the Participant agrees to the terms set out in this Waiver.
§1 — STATUTORY RISK WARNING
This is a warning given under the applicable civil liability legislation of the State or Territory identified in §13 (including, where applicable, the Civil Liability Act 2002 (NSW), the Wrongs Act 1958 (Vic), the Civil Liability Act 2003 (Qld), the Civil Liability Act 1936 (SA), the Civil Liability Act 2002 (WA), the Civil Liability Act 2002 (Tas), the Civil Law (Wrongs) Act 2002 (ACT) or the Personal Injuries (Liabilities and Damages) Act 2003 (NT)) and under the Competition and Consumer Act 2010 (Cth) (including the Australian Consumer Law).
WARNING UNDER THE AUSTRALIAN CONSUMER LAW: Under the Australian Consumer Law (Schedule 2 to the Competition and Consumer Act 2010 (Cth)), several statutory guarantees may apply to the supply of recreational services to you and cannot be excluded. You have the right to a refund or compensation if the services are not rendered with due care and skill, are not reasonably fit for the purpose specified, or do not provide the result you specified.
However, to the extent permitted by section 139A of the Competition and Consumer Act 2010 (Cth) and the applicable State or Territory legislation, the Provider excludes liability for any death, physical or mental injury, or the contraction, aggravation or acceleration of a disease or condition, arising from the supply of the recreational services constituting the Fitness Activity, except to the extent caused by reckless conduct or significant personal injury that the law does not permit to be excluded.
§2 — PARTICIPANT'S HEALTH AND PRE-EXISTING CONDITIONS
Please place an "X" or a check mark next to each statement that is true:
................... I wear a pacemaker.
................... I wear contact lenses.
................... I wear a hearing aid.
................... I wear dentures.
If you experience pain or discomfort in any part of your body, please describe this pain or discomfort, including the location on the body and the cause, if known:
________
Describe your current stress level:
________
List all injuries you have experienced in the past two years:
________
List any health disorders you have, or any areas which may be sensitive to physical touch:
________
List all medications you are taking:
________
List any other information related to your health that may be important for the Provider to be aware of:
________
§3 — ACKNOWLEDGEMENTS AND AGREEMENTS
Please carefully review each clause below. By initialling each clause, you confirm that you have read, understood and agree to it.
................... 3.1 The Fitness Activity may involve a number of exercises or activities including but not limited to: ________
................... 3.2 Participation in the Fitness Activity involves the risks described in the Risk Warning in §1 of this Waiver, and I acknowledge that I have read and understood that Risk Warning.
................... 3.3 I warrant and represent that I understand the nature of the Fitness Activity and the risks involved in it.
................... 3.4 I acknowledge and understand that I am voluntarily choosing to take part in the Fitness Activity and that I am free to refuse to participate at any time.
................... 3.5 I warrant and represent that I am in good health and physical condition.
................... 3.6 I warrant and represent that I do not suffer from any health condition which may affect my ability to safely participate in the Fitness Activity.
................... 3.7 I acknowledge and agree that if I have any concerns or reservations about my health or my ability to participate safely in the Fitness Activity, I must obtain advice from a medical professional before taking part.
................... 3.8 I warrant and represent that if at any time I believe that the conditions of the Fitness Activity are unsafe for me (taking into account my own health and physical circumstances), I will immediately stop participating.
................... 3.9 I understand that if I feel faint, dizzy, nauseous or lightheaded, or experience chest pain or any other pain or discomfort, I must stop the Fitness Activity immediately and notify the Provider or a member of the Provider's staff.
................... 3.10 I understand that the Fitness Activity is intended to be a supportive environment where health and well-being are paramount. Participants progress at different rates and there is no shame in slowing down or taking a break.
................... 3.11 I agree that I know my own body better than anyone else and that it is ultimately up to me to decide whether the conditions of the Fitness Activity are unsafe for me, and to speak up if I have concerns.
................... 3.12 I agree that I will comply with the Provider's rules and any directions given to me by the Provider or the Provider's staff members.
................... 3.13 I warrant that I will compensate the Provider for any damage that I cause to the Provider's equipment or premises as a result of my recklessness or negligence.
................... 3.14 I acknowledge that the Provider is not responsible for the safety or security of my personal belongings while I am taking part in the Fitness Activity. Where the Provider offers lockers or any other place to leave personal belongings, I use these at my own risk.
§4 — WAIVER AND RELEASE
4.2 I release the Provider and the Provider's Representatives from any such Liabilities that I may have or may at any time incur, whether direct or indirect, known or unknown, and whether arising in contract, tort, under statute, in equity or otherwise, except to the extent that such Liabilities cannot lawfully be excluded or arise out of the gross negligence or reckless conduct of the Provider or the Provider's Representatives.
§5 — INDEMNITY
To the maximum extent permitted by law, I agree to indemnify and hold harmless the Provider and the Provider's Representatives from and against any and all Liabilities, including legal costs on a full indemnity basis, arising out of or in connection with my participation in the Fitness Activity, except to the extent that such Liabilities arise out of the gross negligence or reckless conduct of the Provider or the Provider's Representatives, or relate to a right or remedy that cannot lawfully be excluded.
§6 — ASSUMPTION OF RISK
I voluntarily assume all risks associated with the Fitness Activity, whether or not those risks are foreseeable, and I accept full responsibility for any personal injury, death, loss or damage to property, liabilities or other losses that I might incur in relation to the Fitness Activity. I acknowledge that this assumption of risk operates as an "obvious risk" and "inherent risk" acknowledgement for the purposes of the applicable civil liability legislation.
§7 — MEDICAL TREATMENT
I authorise the Provider and the Provider's staff to provide first aid, to seek emergency medical assistance and/or to transport me to a medical facility in the event that I suffer an injury or medical emergency. I acknowledge and accept that I will be responsible for any medical expenses incurred.
§8 — PHOTOGRAPHY AND IMAGES
I authorise the Provider and the Provider's staff to take photographs or video recordings of me while participating in the Fitness Activity and to use such images for promotional purposes, including on social media or other websites. I understand that if I do not wish images of me to be used for promotional purposes, I must notify the Provider in writing. This consent is given in accordance with the Provider's collection and handling of personal information under the Privacy Act 1988 (Cth) and the Australian Privacy Principles.
§9 — PRIVACY
I acknowledge that the Provider collects personal information (including health information) for the purpose of administering the Fitness Activity and providing for my safety. The Provider will handle such information in accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles, and its privacy policy is available on request.
§10 — FINANCIAL NOTICE AND CANCELLATION
10.1 If you wish to cancel an appointment, you are required to give at least the following amount of notice: ________
10.2 If this notice is not received, the following will apply:
________
§11 — ENTIRE AGREEMENT
This Waiver constitutes the entire agreement between the parties in relation to its subject matter and supersedes all prior representations, understandings and agreements, whether written or oral.
§12 — SEVERABILITY
If any provision of this Waiver is found to be invalid, illegal or unenforceable, that provision shall be read down to the extent necessary to make it valid, or otherwise severed from this Waiver, and the remaining provisions shall continue in full force and effect. The invalidity or unenforceability of any provision shall not affect the validity or enforceability of any other provision.
§13 — GOVERNING LAW AND JURISDICTION
This Waiver is governed by, and shall be construed in accordance with, the laws in force in ________ and any applicable Commonwealth (federal) law. The parties submit to the non-exclusive jurisdiction of the courts of that State or Territory and the courts competent to hear appeals from them.
DECLARATION BY THE PARTICIPANT
I have read and understood this Waiver in its entirety. I acknowledge that by signing this Waiver I am giving up certain legal rights which I may otherwise have against the Provider, including the right to sue, to the extent permitted by law. I am assuming all risk and taking full responsibility for any personal injury, death, loss or damage to property, liabilities or other losses which I might incur in relation to the Fitness Activity, and I am engaging in the Fitness Activity at my own risk.
I confirm that I have entered into this Waiver freely and voluntarily, without any inducement, assurance or guarantee being made to me, and that I have had the opportunity to seek independent legal advice before signing. I warrant that I am at least 18 years of age and of sound mind, and that all information I have provided in this Waiver is true and correct.
SIGNED by the Participant:
..............................................
________ (Participant signature & name)
..............................................
Date: ________
WITNESSED by:
..............................................
Witness signature
________
Witness name (print)
________
Witness address
..............................................
Date: ________
Fields you complete are inserted into the document live. This template is general guidance only — not legal advice.