Name *

First Name

Last Name

Address *

Address 1

Address 2

City

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Phone *

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Check all that apply

Gym Membership

Personal Training

Spa Services

New BioHacking Services

Cryo T-Shock Fat Reduction

Has a doctor ever said you have heart trouble? *

Yes

No

Do you frequently experience chest pain? *

Yes

No

Has a doctor ever told you that you have joint or bone problems worsened by exercise? *

Yes

No

Do you have any medical conditions? *

Yes

No

Is there any other reason you should not engage in physical activity? *

Yes

No

Please check the box below *

I agree not to attend if experiencing symptoms of a contagious illness.

I understand that photographs or videos may be taken during activities for marketing purposes. I consent (or do not consent) to the use of my image. *

I consent

I do not consent

Today's Date *

MM

DD

YYYY

Guardian Date

MM

DD

YYYY

In consideration of being permitted to participate in exercise programs, personal training, lifestyle coaching, and/or use of the facilities and equipment at The Spa at Yellow Creek and The Gym at Yellow Creek, I, on behalf of myself and any person or entity claiming through me (including but not limited to heirs, administrators, and executors), knowingly and voluntarily waive, release, discharge, and covenant not to sue The Spa at Yellow Creek and The Gym at Yellow Cree, its employees, officers, directors, shareholders, agents, successors, and assigns, from any and all claims, liabilities, injuries, damages, or death arising directly or indirectly from my participation, membership, or use of its facilities and/or programs, whether arising from negligence or otherwise. I understand that participation in physical activities carries inherent risks, including but not limited to dizziness, fainting, nausea, muscle strains, sprains, fractures, musculoskeletal injuries, cardiovascular events (such as heart attack or stroke), allergic reactions, and other risks associated with exercise and dietary programs. I acknowledge that i have been advised and encouraged to seek medical clearance from my physician before beginning any exercise or lifestyle program. I voluntarily assume full responsibility for all risks, injuries, or damages, including death, that may arise from my participation. If I am pregnant, I also voluntarily assume full responsibility for risks to my unborn child. I agree not to attend the facility if I am experiencing symptoms of any contagious illness, including but not limited to COVID-19, influenza, or other communicable diseases, unless cleared by a physician. This agreement is governed by the laws of the state of Ohio, and any disputes shall be resolved exclusively in the Common Pleas Court of Summit County, Ohio. By submitting this waiver, I certify that I have read, understand, and voluntarily accept the terms and conditions outlined above. *

I Agree

Personal Property Disclaimer (Lost or Stolen Items) I understand and agree that The Spa at Yellow Creek is not responsible for the loss, theft, or damage of any personal belongings brought into or left at the facility, including in lockers, treatment rooms, or common areas. I acknowledge that I am solely responsible for securing my own personal property during my visit. *

I Agree