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The Gr8s Health & Wellness

Contact Information

First Name

Last Name

Phone #

Emergency contact

Do you have any underline health Issues that may impair your ability to partake in physical activity

Yes

List any Underline Health Issue effecting/ pertaining to

Heart

Lungs

Diabetes

High Blood Pressure

Other

N/A

As a participant of The Gr8s Health and Wellness Corp, I understand that physical exercise can be strenuous and subject to risk of serious injury. You are urged to obtain a physical examination from a doctor before participating in any exercise activity. I agree that if I engage in any physical exercise or activity, I so entirely at my own risk. I hereby release, forever, and discharge The Gr8s Health & Wellness Corp, their respective management, partners, agents, contractors, employees, volunteers, and interns (whether within scope of their employment or not) from any claims, demands, or cause of action relating to or arising from presence or participation in The Gr8s Health & Wellness program, which may result in injury to me or even death. I intend this release to bind my heirs, executors, assigns, administrators, personal representative, and myself.

I do Agree

I Disagree

Electronic Signature

First Name

Today's Date

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