St. Joseph, Illinois




Group Fitness Waiver and Release Form


I,_______________________________, acknowledge that a Group Exercise Program is designed to improve my personal fitness by providing personalized and motivational attention by an instructor.  I recognize that the Group Instructor does not have any certification or formal training.  I understand that there may be health risks associated with activities using physical exertion in a Group Exercise Program.  The health risks include, but are not limited to, transient dizziness, fainting, nausea, muscle cramping, musculoskeletal injury, sprains and strains, heart attack, stroke, sudden illness or death.  If I experience any of these or any other symptoms while exercising, I will discontinue the activity, notify the group instructor, and consult my physician.


I certify that I am capable of performing physical exercise and acknowledge that I am voluntarily participating in this Group Exercise Program.  I am participating in the Group Exercise Program with knowledge of the dangers involve.  I understand that I will be fully responsible for complying with any restrictions prescribed for me by my personal physician and that I agree to consult my personal physician for further evaluation and such medical care as I require. 


I acknowledge that my participation in the Group Exercise Program is at my sole risk.  I agree that I am voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death.  The village is also not responsible for any loss of my personal property. 


I acknowledge that I have carefully read this “waiver and release” and fully understand that it is a release of liability.  I expressly agree to release and discharge the trainer or instructor from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action against the trainer or instructor for personal injury or property damage.


To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.


If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.


By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.




Printed Name:_______________________                   Date:_________________