LiftOMania III [Women’s]

NAME *

WEIGHTLIFTER/wrestler TITLE (optional-can be added or changed later)

EMAIL *

BIRTH YEAR (YYYY) *

USAW ID# *

Barbell Club / Affiliation *

DIVISION *

WEIGHT CLASS *

Entry Total *

UNISEX T-SHIRT SIZE *

INSTAGRAM HANDLE

If you want us to tag you in any footage or photography from the event.

Waiver & Health Info Paramount Strength & Conditioning LLC DBA CrossFit Paramount 22402 44th Ave W. STE A, Mountlake Terrace WA 98043 PHOTOGRAPHY/VIDEO RELEASE Participants involved in any activities offered by Paramount Strength & Conditioning may be photographed or videotaped during training. The undersigned hereby consents to the use of the photographs and/or videos without compensation, on the Paramount Strength & Conditioning website or in any editorial, promotional or advertising material produced and/or published by Paramount Strength & Conditioning and its affiliates. WAIVER AND RELEASE OF LIABILITY Express assumption of risk: I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; strain, sprains and metabolic conditions such as DOMS (Delayed Onset Muscle Soreness). I am aware that any of these above mentioned risks may result in serious injury or death to myself or my partner(s). I willingly assume responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participating in any activity or class while at, or under direction of Paramount Strength & Conditioning. I acknowledge and represent that I have no physical impairments, injuries, or illnesses that will endanger myself or others. Medical Checkup: I, the undersigned, understand that the activities available Paramount Strength & Conditioning may involve strenuous physical activity and that a medical check-up is advisable before participating in any fitness program. I further understand that neither the owner nor employees of Paramount Strength & Conditioning are medical doctors, therefore I should see a medical doctor of my own choosing before participating in any fitness program. I recognize, appreciate and understand the danger of physical stress, strain or injury (including but not limited to cardiac arrest, stroke, changes in blood pressure, muscle strains, sprains and ligament and/or tendon damage and other physical problems that may arise) that may result from any activity that requires physical exertion and accept these risks. Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by Paramount Strength & Conditioning, I, the undersigned, hereby release Paramount Strength & ConditioningCrossFit Paramount, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in activities, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. Express consent for medical treatment: I expressly give my consent for the staff and coaches of CrossFit Paramount to obtain medical care from any licensed physician, hospital, clinic or paramedic for any injury or illness that may arise during activities associated with CrossFit Paramount. If I am signing on behalf of a minor child, I also give full permission for any person connected with CrossFit Paramount to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child. Indemnification: I, the undersigned, recognize that there is risk involved in the types of activities offered by Paramount Strength & ConditioningCrossFit Paramount. Therefore, I accept financial responsibility for any injury that I may cause either to myself or to any other participant due to my negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I furthermore agree to indemnify and hold harmless Paramount Strength & Conditioning, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act of omission while participating in activities offered by Paramount Strength & Conditioning, whether at home, at the training studio, outdoors, or at a corporate, commercial, residential or other fitness facility. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by Paramount Strength & Conditioning. I have read and understood the foregoing assumption of risk and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights. PERSONAL RESPONSIBILITY: I understand that I am not obligated to perform nor participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during my training sessions. I understand that should I feel lightheaded, faint, dizzy, nauseated, or experience pain or discomfort, I am to stop the activity and inform my Trainer. *

I UNDERSTAND

REGISTRATION *

ATHLETE

These transactions are non-refundable.

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