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  • I have been informed and understand that participation in running, strength, conditioning, flexibility and athletic training programs, including the use of equipment, are potentially hazardous activities. I also understand that fitness activities involve a risk of injury, including a remote risk of death and serious disability and that I am voluntarily participating in these activities and use of equipment and machinery with full knowledge, and understanding of the possible dangers involved. I agree and accept and all risk of injury or death. 

  • I further declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation in these exercises, activities, programs, and use of equipment/machinery. I understand the Breakout PPT provisions and maintenance of an exercise/fitness program for me does not constitute an acknowledgement, representation indication of my physiological well being or medical opinion relating thereto. 

  • I acknowledge that I have been informed of the need for a physician’s approval for my participation in the exercises, activities, programs and use of equipment. Or that I have decided to participate in these exercises, activities, programs and use of equipment without the approval of my physician and hereby assume all responsibility for my participation in said exercises, activities, programs and use of equipment. 

  • In consideration of being allowed to participate in a personal rehabilitation/fitness training activities and programs of Breakout PPT, and to use equipment and services, in addition to the payment of any fee or charge, I do hereby forever wave release, and discharge Breakout PPT, from any claims, or liabilities for injuries or damages to my person and/or property, including those caused by a negligent act or omission, arising out of, connected to or recommended by Breakout PPT. 

  • I understand and agree that Breakout PPT and its staff are not liable for loss or damage of personal property. 


   I have read and understand the above policies and agree to abide by its guidelines:


____________________________________________                              ______________________

Signature of client or responsible party                                                       Date

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