Health + LIABILITY Waiver

To subscribe for a Body By Rocco (BBR Athletics) Fitness Plan, Nutrition Plan and/or membership at The Annex - please fill out the following form:

First Name

Email Address

Last Name

Birthday

Emergency Contact

Emergency Contact Number

Do you have any pre-existing / current injuries or medical conditions?

Yes (please consult with your primary care physician before starting this program)

I agree that by participating in physical exercise or training activities, I do so entirely at my own risk

I acknowledge and accept full responsibility for limiting, replacing and/or not completing any prescribed movements and/or exercises should I be physically unable to do so properly and safely.

I agree that I am voluntarily participating in these activities and the use of these facilities and premises (if applicable). Further, I assume all risks of mental/psychological anguish, strain, and/or trauma. I accept full responsibility for any physical injury, illness, and/or death.

I acknowledge and accept full responsibility of "OFF HOURS ACCESS", if applicable. This includes my personal safety, the facility and the equipment within the facility. I take full responsibility of all inventory as well as the condition of the inventory while I am present. I acknowledge that it is my responsibility to lock the door upon entering and exiting during "OFF HOURS".

Initials

Today's Date

By signing below, you acknowledge that you have carefully read this “waiver and release,” answered all questions honestly and fully understand that it is a release of liability. You expressly agree to release and discharge the business (BBR Athletics / Body By Rocco / The Annex) and the trainer (including but not limited to Rocco Di Jerlando) from any and all claims or causes of action. You agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the trainer and/or company for personal injury, property damage or worse. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.

Your Signature

Health + LIABILITY Waiver

THE ANNEX || 1053 E. Edna Pl. Covina, CA 91724