SIGNUP / VISIT
- Billed Every Week until cancelled
Please verify or update your start date.
Membership start date
I understand this charge and understand that there are no refunds.
Enter exactly 4 numbers, for future kiosk checkouts
Emergency contact name
Emergency contact phone
How did you hear about us?
-- Select One --
Google / Web Search
Referred By Member
Heard about us other
Birthday - Month
-- Month --
Birthday - Day
-- Day --
Birthday - Year
-- Year --
Please answer the following questions
Photography/Video Release Participants involved in any activities offered by CrossFit Triple City may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the CrossFit Triple City website or in any editorial, promotional or advertising material produced and/or published by CrossFit Triple City.
Waiver and Release of Liability Express assumption of risk:I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; strains and sprains. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of CrossFit Triple City. I acknowledge that I have no physical impairments, injuries, or illnesses that will endanger me or others. [initial]
Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by CrossFit Triple City , I, the undersigned hereby release CrossFit Triple City, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with CrossFit Triple City to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child.
Indemnification: The participant recognizes that there is risk involved in the types of activities offered by CrossFit Triple City. Therefore the participant accepts financial responsibility for any injury that the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless CrossFit Triple City, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by CrossFit Triple City, at the main building or abroad. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by CrossFit Triple City.
I have read and understood the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights
Any injuries or issues that would affect your workouts or progress?
RELEASE For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby grant to PNW Athletics & Nutrition (DBA CrossFit Triple City) (the “Gym”) and each of its subsidiaries and affiliates, officers, directors, agents, contractors, contracting parties, consultants, advertisers, successors, assigns, licensees, servants and employees, and those acting with its permission (collectively, with the Gym, the “Authorized Parties”) an unrestricted, irrevocable, exclusive, royalty-free, world-wide, perpetual, sublicensable, assignable, license to use, reproduce, edit, modify, publish and/or broadcast all or any part of the personal photograph(s), videotaped likeness and other information that I have provided to the Gym, including my name, likeness, image, voice, biography, oral and written statements, digital images, and recordings of me (collectively, “Images and Likeness”) in any and all media now known or hereafter developed with or without credit to me. I acknowledge that the Authorized Parties, in their discretion, may choose not to use the Images and Likeness. I hereby assign to the Gym all copyright, title and interest in and to the Images and Likeness, including the entire worldwide copyright and all renewals, reversions and extensions thereof, and waive all rights of “droit moral” or “moral rights of authors” or any similar rights or principles of law that I may now or hereafter have in the Images and Likeness. I further agree to execute and deliver to the Gym any further documents and do any further acts that may be deemed reasonably necessary by the Gym to perfect or protect the rights and title to the Images and Likeness herein conveyed or intended to be conveyed. I understand and agree that the Authorized Parties in their sole discretion may (i) reproduce, digitize, modify, change, alter, adapt, or otherwise make use of the Images and Likeness, and (ii) edit, delete and/or use some or all of Images and Likeness alone or with other materials, including without limitation text, data, images, photographs, illustrations, animation, graphics, and video or audio segments. I understand and agree that I shall have no right to review, approve or edit the manner of use or exploitation of the Images and Likeness, or the right to revoke the rights granted herein. I further understand that the Gym is and shall be the exclusive owner of all right, title and interest (including copyright) in and to all embodiments of the Images and Likeness. I understand and agree that the Images and Likeness, may be distributed to the public. I understand and agree that I do not and shall not have or retain any rights, including without limitation trademark rights, copyright rights, or publicity rights, the Images and Likeness. I agree that in no event shall the Authorized Parties be liable for any damages whatsoever arising out of or related to my submission of the Images and Likeness, including, but not limited to direct, indirect, incidental, special, consequential or punitive damages, whether under a contract, tort, or any other theory of liability, even if the Authorized Parties are aware of the possibility of such damages. I hereby release the Authorized Parties from, and shall neither sue nor bring any proceeding against any such parties for, any liability, loss, demands, injuries, damages, claims or causes of action, whether now known or unknown, arising out of or relating to the use of the Images and Likeness. I represent that the Images and Likeness are original, have not been previously published, do not contain any material that would defame or otherwise violate or infringe upon the rights of any third party, including patents, copyrights, trademarks or rights of privacy or publicity, and will not violate any federal, state or local laws or ordinances. I further represent that (i) I have secured the requisite consent from all third parties (including the consent of legal guardians for all minors) referenced or appearing in Images and Likeness and for all third-party content depicted in the Images and Likeness; (ii) the consent of no other person, firm, corporation, or labor organization is required to enable the Authorized Parties to own and use the Images and Likeness or any portion thereof; and (iii) such ownership and use(s) of the Images and Likeness by the Authorized Parties will not violate the rights of any third parties. I represent that I am of full age and have the right to contract in my own name, and I have read the foregoing and fully understand the meaning and effect thereof, and intending to be legally bound I have acknowledged and agree to this Release.
Please use your mouse/finger to sign your name
By clicking this checkbox you agree to online signature signing of this waiver
Enter Credit or Debit Card Information
I consent to conduct electronic business
We believe that you are never too young or too old to begin your journey of health and fitness. At CrossFit Triple City, you will find a community of people who are dedicated to getting stronger, and healthier every day and have fun doing it,
3901 Southeast Naef
portland, OR 97267
Triib, Inc Copyright © 2018
- All Rights Reserved
Powered by Triib, Inc