In consideration of PT360 , trading as 'Dublin Throwdown' allowing me to participate, I acknowledge, understand and am aware that:
I have voluntarily chosen to participate in training activities & competition provided by PT360 . t/a Dublin Throwdown, at Dublin Indoor Soccer Dome, Sports Complex, Santry, Dublin, D09 V8XT. I understand that there are inherent risks in all aspects of physical training, competing in competition and I acknowledge that I have been informed of the possible strenuous nature of the training and the potential for undesirable physiological results including, but not limited to, abnormal blood pressure, muscle soreness, fainting, heart attack and/or death. I also acknowledge that I have been specifically warned about the medical condition ‘Rhabdomyolysis’ and accordingly I have been advised to limit my effort in order to minimise the risks associated with this condition
I understand that the training may involve weightlifting, gymnastic movements, strenuous bodyweight exercises and other high exertion activities, and that I am not obligated to perform nor participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during my training sessions or competition. I understand that should I feel lightheaded, faint, dizzy or nauseated, or experience pain or discomfort, I am to stop the activity and inform a staff member. I give PT360 . t/a Dublin Throwdown and the staff of the facilities I train/compete in permission to seek emergency medical services for me should I become injured or ill with the understanding that I am responsible for any expenses incurred.
I agree to WAIVE ANY AND ALL CLAIMS that I have or may have in the future against PT360 . t/a Dublin Throwdown, and its directors, officers, employees, agents, volunteers and independent contractors (all of whom are hereinafter collectively referred to as ‘the Releasees’). I agree to RELEASE THE RELEASEES from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer as a result of my participation in the programs, activities and services provided by PT360 . t/a Dublin Throwdown, due to any cause whatsoever including negligence, breach of contract, or breach of any statutory or other duty of care. I agree to HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damage to the property of or personal injury to, any third party, resulting from my participation in any program, activity or service provided by the releases.
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 in behalf of a minor child, I also give full permission for any person connected with PT360 . t/a Dublin Throwdown, to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child.
Use of picture(s)/film/likeness: I agree to allow PT360 . t/a Dublin Throwdown its agents, officers, principals, employees and volunteers to use picture(s), film and/or likeness of me for advertising purposes. In the event I choose not to allow the use of the same for said purpose, I agree that I must inform PT360 . t/a Dublin Throwdown of this in writing.
I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS ‘INFORMED CONSENT FORM’ I AM WAIVING CERTAIN LEGAL RIGHTS (INCLUDING THE RIGHT TO SUE) WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTOR, ADMINISTERS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION.
