Signup

GYM WAIVER AND RELEASE AGREEMENT

Facility: Origin Gym (Build Your Better You LLC)
Location: [5830 McCann Dr. Baton Rouge, LA 70809]

I, the undersigned, wish to use the facilities and participate in activities provided by
Origing Gym. By signing this waiver, I acknowledge and agree to the following terms:

Participant Information:
 Full Name: {name}
 Date of Birth: {dob}
 Address: {address}
 Phone Number: {phone}
 Emergency Contact: [Name and Phone Number] {contact_name}, {contact_phone}

Assumption of Risk:
I acknowledge that using gym facilities, equipment, and participating in physical
exercise involves inherent risks, including but not limited to physical injury, strain,
discomfort, and the possibility of serious injury or death. I assume all risks and
responsibility for any injuries or other medical incidents.

Waiver and Release:
I hereby release, waive, discharge, and agree not to sue Origin Gym, its employees,
representatives, affiliates, or agents from any claims, demands, liabilities, rights,
damages, expenses, and causes of action of any nature arising from my use of the gym
facilities, whether caused by the negligence of Origin Gym or otherwise.

Medical Representation:
I represent that I am physically fit to use the gym facilities and participate in physical
exercise. I have no medical condition that would prevent my safe participation. If I have
any medical conditions or concerns, I have consulted with a healthcare provider and
obtained clearance to participate.

Rules and Regulations:
I agree to abide by all rules, regulations, and policies of Origin Gym, including proper
use of equipment, following safety guidelines, and respecting other members and staff.

Consent to Medical Treatment:
I hereby consent to receive any necessary medical treatment resulting from my use of
the gym facilities and agree to bear all costs associated with such treatment.

Acknowledgment:
I have read this Gym Waiver and Release Agreement, understand its contents, and
agree to be bound by its terms. I understand that I am giving up substantial legal rights
by signing this document.

Date: {sign_date}
Name of Parent/Guardian Signing (if under 18):

Origin Gym
info@origingym.us
225-400-8090
5830 McCann Dr. Baton Rouge, LA 70809