Xtreme Fitness670

Online Registration · Liability Waiver · Health Declaration

Free community fitness • Donations optional

Regular classes only. All participants must complete the registration and applicable waiver before joining. Minors require a parent/legal guardian signature. Special events require separate registration and waiver. Submissions remain unavailable until the administrator completes security and database testing.

1. Participant information

2. Confidential health declaration

Required. Only authorized Xtreme Fitness670 administrators should access submitted records. Avoid providing diagnoses or unnecessary medical details.

Health status *

I agree to stop exercise and notify an instructor if I experience chest pain, unusual shortness of breath, faintness, or other concerning symptoms.

Physical activity readiness questions

Please answer all seven questions. If you answer YES, speak privately with an instructor about appropriate precautions before participating.

1. Has a doctor ever said that you have a heart condition or high blood pressure?
2. Do you feel pain in your chest at rest, during daily activities, or when exercising?
3. Do you lose balance because of dizziness, or have you lost consciousness in the last 12 months?
4. Have you ever been diagnosed with another chronic medical condition?
5. Are you currently taking prescribed medications for a chronic medical condition?
6. Do you have a bone, joint, or soft-tissue problem that could be made worse by becoming more physically active?
7. Has your doctor ever said that you should only do medically supervised physical activity?

3. Participation agreement and liability waiver

Read the entire agreement before signing.

1. Voluntary Participation

I voluntarily request to participate in Xtreme Fitness670 activities, including Zumba, dance fitness, toning, strength training, stretching, and other fitness programs. I understand that participation is optional and that I may stop any activity at any time.

2. Understanding and Assumption of Risks

I understand that physical activity involves risks, including slips, falls, collisions, strains, sprains, muscle soreness, dehydration, dizziness, changes in blood pressure, aggravation of existing conditions, and, in rare cases, serious injury or death. I agree to participate within my own abilities, follow safety instructions, and promptly stop and inform an instructor if I feel unwell.

3. Health Declaration and Personal Responsibility

I confirm that I have answered the confidential health declaration on this form truthfully. I understand that Xtreme Fitness670 instructors are not providing medical diagnosis or treatment. I am responsible for seeking medical advice when appropriate before participating and for informing instructors of any limitation that affects safe participation. I may decline to disclose detailed diagnoses on this paper and instead discuss necessary activity restrictions privately with an authorized administrator.

4. Release of Liability

To the fullest extent permitted by applicable Commonwealth of the Northern Mariana Islands law, I release and agree not to hold liable Xtreme Fitness670, its directors, officers, instructors, volunteers, and authorized representatives for claims arising from the ordinary risks of my voluntary participation or their ordinary negligence. This release does not apply to gross negligence, reckless or intentional misconduct, or any liability that cannot lawfully be waived.

5. Emergency Response

If I appear to need urgent medical attention, I authorize Xtreme Fitness670 representatives to contact emergency services and my emergency contact. I understand that I am responsible for any medical costs incurred, to the extent permitted by law. Xtreme Fitness670 does not guarantee the availability of medical personnel at classes.

6. Rules and Personal Belongings

I agree to follow posted safety rules, use equipment only as instructed, supervise any child for whom I am responsible, and respect other participants. I understand that Xtreme Fitness670 is not responsible for lost or unattended personal belongings except as required by law.

7. Acknowledgment and Signature

I have read this entire agreement, understand its terms, have had the opportunity to ask questions, and sign voluntarily. I understand that signing may affect my legal rights. This signed paper form is intended to serve as my walk-in registration and waiver for regular classes; special events may require a separate event-specific form.

4. Optional photo/video consent

Choose one *

5. Electronic signature

For participants under 18, the parent/legal guardian must also complete the guardian signature above.