#1 Community Event – Workout Sign Up Form IFD HIT is hosting a community workout event on Saturday, March 21st.Sign up here to join! InstagramThis field is for validation purposes and should be left unchanged.Name(Required) First Last Date of Birthmm/dd/yyyyGender Male Female Where are you coming from?(Required) Zip Code Phone(Required)Email(Required) How did you hear about us? Facebook Instagram Newspaper Fire Department Friend Other Will you be a participant or a spectator? Participant Spectator WAIVER AND RELEASE OF LIABILITY(Required)Organization: KDH Fitness Activity: CrossFit (the "Activity") 1. ASSUMPTION OF RISK IN CONSIDERATION OF the risk of injury that exists while participating in the Activity and my desire to participate in said Activity, I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY. I am aware of the risks associated with participating in this activity, which may include, but are not limited to: ● Physical or psychological injury, pain, and suffering. ● Illness, disfigurement, or temporary/permanent disability (including paralysis). ● Economic or emotional loss, and death. I understand these outcomes may arise from my own or others' negligence, conditions related to travel, or conditions at the location. I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME. 2. RELEASE AND INDEMNIFICATION I HEREBY release and forever discharge KDH FITNESS and their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releasees"), from any physical or psychological injury that I may suffer as a direct result of my participation. I FURTHER AGREE to indemnify, defend, and hold harmless the Releasees against any and all claims, suits, or actions of any kind whatsoever for liability, damages, or compensation brought by me or anyone on my behalf, including attorney's fees and related costs. 3. MEDICAL AUTHORIZATION & INSURANCE In the event that I should require medical care, I authorize KDH Fitness to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. ● I agree to be financially responsible for any costs incurred as a result of such treatment. ● I acknowledge that I should carry my own health insurance. 4. PARTICIPANT OBLIGATIONS ● Physical Fitness: I agree not to participate unless I am medically able and properly trained. I will abide by the decisions of any KDH Fitness official regarding my ability to participate. ● Property Damage: I agree to be held liable for any costs associated with damage to equipment or facilities caused by my (or my family’s) willful actions, neglect, or recklessness. 5. GENERAL PROVISIONS ● Governing Law: This Release shall be governed by South Carolina law. ● Severability: If any portion of this agreement is deemed invalid or unenforceable, the remainder of the agreement shall remain in full force and effect. ● Duration: This waiver remains in effect for the duration of my participation in the Activity, including all subsequent events. ACKNOWLEDGMENT OF UNDERSTANDING: I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I AM AWARE THAT THIS IS A CONTRACT AND THAT I AM SIGNING IT OF MY OWN FREE WILL.Participant Name(Required) (Print) Participant Signature:(Required)Parent/Guardian Signature (If participant is under 18):Would you like to Pre-Order an event T-shirt Yes No Credit Card Cardholder Name Card Details Pre-Order T-ShirtAdult SmallAdult MediumAdult LargeAdult X-LargeAdult 2XAdult 3XQuantityWould you like e-mail updates from our sponsors Town of Irmo Bear Tree Care MaxLiving South Carolina Blue Shield Lexington Health