I,
the undersigned, have read, understand, and have answered the above
survey/questions fully and truthfully. I am aware of my
responsibilities to consult with my personal physician regarding my medical
fitness to engage in exercise. I do herby intend to be legally
bound for myself and waive release of any and all rights and claims for
damages I may have against the training facility, Jiva, and the
exercise professional administering the exercise program provided to me.