Waiver & Release of Liability

If you have NEVER been to GoodLife and are NOT a Participant, you will need to fill out a participant form and waiver. You only need to do this ONCE. If you’d like to save time at check in, please fill out the form below.

* indicates a required field

Full Name*

Date of Birth*

Your Email*

Address*

City*

State*

Zip Code*

What is the best number to reach you at?*

Secondary Phone Number*

Allergies*

Medical Conditions*

Physician's Restrictions*

Are you a veteran?*

Please tell us how you heard about us?*


Emergency Contact Information

Emergency Contact Name*

Relation*

Emergency Contact Number*

Release: I understand and agree that the information contained on this form may be released for statistical purposes, and I agree to the release of information for that limited purpose only. I understand that any release of information in identifiable form must be accompanied by a signed consent form and that the information will not be used as an eligibility determination or affect participation as a recipient unless a law has specifically restricted program participation. I understand that GoodLife Programs and Activities does not/will not sell any participant information to anyone.

Waiver & Release of Liability: I understand that participating in any program offered by GoodLife Programs & Activities including but not limited to sports, exercise, wellness, health, entertainment, social or travel programs may involve inherent
risks and dangers. I also understand that even when reasonable precaution is taken, risk remains inherent and accidents and/or injury can still occur. I acknowledge that I am a willing and voluntary participant in such activities, that I am aware of these risks and accept all responsibility for any damages or personal injury that may occur as a result of my participation.

I declare myself to be physically sound and suffering from no condition, impairment, disease or other illness that would prevent my participation in any programs at GoodLife Programs & Activities. I acknowledge that it is my responsibility to monitor my own condition and share pertinent medical information with the staff, should it present an impediment to safe participation in my selected Center activities. Furthermore, I agree should that be the case, that I will cease participation in such activities until such time as I secure and present a signed authorization form from my physician.

I do hereby waive and release any and all rights and claims against The GoodLife Programs & Activiti8es, Inc., its employees,agents, volunteers, instructors and independent contractors from any and all liability for personal injuries or property damage resulting from my use of GoodLife Programs & Activities’ facilities, participation in travel program and/or programming by my voluntary participation.

I have read this entire document, understand it completely and agree to the above.*