I, the undersigned, hereby declare through this consent form that I have voluntarily enrolled in a fitness program offered
through Burn45 LLC. I recognize that the program may involve strenuous or hazardous physical activity including, but not
limited to, muscle strength and endurance training, cardiovascular conditioning and training, activities that present a risk
of injury from accident(such as cycling, HIIT training or weight training), and other various fitness activities.
I, the undersigned, hereby affirm that I am in good physical condition and do not suffer from any known disability or
condition which would prevent or limit my participation in this exercise program. I have been advised that an
examination by a physician should be obtained by anyone prior to commencing a fitness and/or exercise program, or
initiating a substantial change in the amount of regular physical activity performed. If I have chosen not to obtain a
physician’s consent prior to beginning this fitness program, I hereby agree that I am doing so solely at my own risk. I
understand that it is my sole responsibility to participate in exercises that are appropriate for the current status of my
health. If I have any questions or concerns about whether or not a particular activity and/or nutrition recommendation is
appropriate to my current health status, I understand it is my responsibility to ask my doctor if this activity is appropriate
before I participate in such activity.
I, the undersigned, understand that this program is not medically supervised, and exercise activities are led by
independent fitness instructors or other program participants. I acknowledge that BURN45 LLC does not have a
physician, licensed dietitian or licensed nutritionist professional.
I, the undersigned, understand that any exercise or fitness activity involves a risk of injury, as well as abnormal changes
in blood pressure, fainting, and a remote risk of heart attack, stroke, other serious disability or death. I am accepting
such risks and volunteering to participate with a full understanding of the dangers involved. In consideration of my
participation in this program, I, hereby waive and release BURN45 LLC and its successors and assigns, from any and all
claims, costs, liability and expense for any injury, loss or damage whether known, anticipated or unanticipated arising
from my voluntary participation and enrollment, specifically including, without limitation, any claims arising from the
actions or omissions of any independent instructor or other program participants. I understand that I may be asked by
an independent instructor to sign a separate waiver of liability and may not be able to hold the instructor responsible for
any injuries I may suffer.
I, the undersigned, grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any
other record of any legitimate promotional purposes for BURN45 LLC.
I, the undersigned, acknowledge that I have thoroughly read this form in its entirety and
fully understand it. I understand that it contains a release of liability. By signing this
document, I am waiving all rights I or my successors might have to bring a legal action or
assert a claim against BURN45 LLC. I represent that I am at least 18 years of age (or have a
legal guardian present), have read and understand the foregoing statement, and am
competent to execute this agreement.