Youth Liability Agreement

Peaks Island Strength and Wellness LLC
Youth Participation Agreement & Liability Waiver

Peaks Island Strength and Wellness LLC ("PISW") is an islander-owned and operated business designed to help everyone in our community in their efforts to pursue healthy, fit lifestyles. The path to fitness is very much a matter of individual choice and determination, with numerous variables influencing outcomes. We sincerely hope your child finds our facility to be a user-friendly resource that capably meets their various fitness and wellness needs.

In exchange for good and valuable consideration, being my child's access to and opportunity to use PISW facilities and equipment, the receipt of which I acknowledge, the following terms and conditions are accepted by me as the parent or legal guardian:

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(Print Parent/Guardian Name): __________________________

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Rules/Conditions of Participation:

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• I confirm that my child is physically fit and mentally capable of performing the physical activity they choose to participate in. I have been advised to obtain a physical examination from a doctor before my child participates in any exercise activity. (Print initials): ________

• I understand that my child will be participating in a supervised fitness class led by a qualified instructor. While the instructor will provide guidance and oversight, I acknowledge that physical activity carries inherent risks, and my child’s participation is at their own risk. (Print initials): ________

• I am aware that physical exercise, whether using equipment or not, can be strenuous and can expose my child to risks of accident, injury, disabling condition, or death. I assume any and all risk of injuries associated with participation, including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, and all other such risks being known and appreciated by me. (Print initials): ________

• I agree that my child will comply with all rules imposed by Peaks Island Strength and Wellness LLC regarding the use of the facilities and equipment. My child will conduct themselves in a controlled and reasonable manner at all times and will refrain from using any equipment in a manner inconsistent with its intended design and purpose.  (Print initials): ________

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Waiver of Liability/Release of Claims/Indemnification:

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• I agree, on behalf of my child, my heirs, executors, administrators, successors, and assigns, that PISW and its insurers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by my child, in, on, or about the premises, or as a result of the use of the equipment or facilities. (Print initials): ________

• I assume full responsibility (hereby waiving whatever rights I possess or may in the future possess against PISW) for any injuries, damages (both economic and non-economic), and losses of any type, which may occur to my child. I fully and forever release and discharge PISW, its insurers, employees, officers, directors, and associates from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether known or unknown, anticipated, or unanticipated, resulting from or arising out of the use of said equipment and facilities. (Print initials): ________

• I agree to indemnify and hold PISW harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by my child. (Print initials): ________

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Applicable Law:

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The provisions of this Agreement, including but not limited to the Waiver of Liability/Release/Indemnification provisions, are governed by the Laws of the State of Maine. If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed herefrom. This release cannot be modified orally. (Print initials): ________

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Supervision:

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• The youth fitness class will be led by an independent qualified instructor. While instruction and supervision will be provided, parents/guardians acknowledge that participation in physical activity carries inherent risks.

• The parent or guardian is responsible for ensuring that their child follows all gym rules and expectations during the class.

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Gym Rules and Expectations:

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To ensure a safe and positive environment for all participants, the following rules must be followed at all times:

1. Respect – Participants must be respectful toward trainers, fellow classmates, and the facility. No foul language, bullying, or inappropriate behavior will be tolerated.

2. Safety First – Participants must keep their hands to themselves. No horseplay, roughhousing, or fighting is allowed.

3. Facility Conduct – Equipment must be used properly and returned to its designated place after use. Any damages caused by misuse may result in financial responsibility.

4. Surveillance Notice – The gym is monitored by video cameras at all times for security purposes. Footage is not actively watched but may be reviewed if needed for security, damage assessment, or other necessary purposes. By signing below, parents/guardians acknowledge and consent to this surveillance.

5. Personal Responsibility – Participants are expected to follow the trainer’s instructions at all times to prevent injury and ensure a productive workout environment.

6. Health and Fitness Disclosure – If the participant has any medical conditions, injuries, or physical limitations, it is the responsibility of the parent/guardian to disclose this information prior to participation.

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Wherefore...

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By signing this Agreement, I recognize and agree that accessing the facilities of Peaks Island Strength and Wellness LLC is a valuable privilege for my child, and that I have read, understand, accept, and agree to all of the foregoing terms and conditions.

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Parent/Guardian Signature: __________________________
Printed Name: __________________________
Date: __________________________

Participant’s Name: __________________________
Participant’s Age: __________________________

 

Acknowledgment of Rules:

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By signing below, I acknowledge that I have read and understand the gym rules, and I agree to abide by them at all times.

Participant’s Signature: __________________________
Participant’s Printed Name: __________________________
Date: __________________________

 

Thank you for your cooperation and commitment to a healthy lifestyle!

 

Sincerely,

The Peaks Island Strength and Wellness Team