Fitness'center'Waiver TDS-21800
Fitness Center Waiver Form
Employee Name: ______________________________________________
Contact #:_________________________ Work #:____________________________
Physician’s Name: __________________ Phone #:____________________________
Emergency Contact:
Name: _____________________________ Phone: _____________________________
I assume all responsibility for all risk, damage, or injury that may occur to me while
using the Tulalip Tribes Administration Building Fitness Center or participating in an
aerobics or fitness class, including damage or injury to me while under the direction of
any Tulalip Tribes employee or volunteer. In consideration of being accepted for such
training or instruction, I hereby release and discharge Tulalip Tribes and its employees
and/or volunteers from claims, demands, damages, rights or causes of action, present or
future, whether the same be known, anticipated or unanticipated, resulting from or arising
out of, or incident to, my fitness, body-building, or exercise training, or my use of any
facilities and equipment in the Fitness Center.
A physician’s approval will be secured by me if there are any known or unknown
medical or physical conditions that make it dangerous or unwise for me to use fitness
equipment or participate in aerobic exercise.
I have read and understand and sign this agreement and release,
on this _______day of __________, 20___.
Employee Signature:
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