1461 A First Avenue #169, New York City, New York 10021-2201 — Phone (212)717-2294

Release Form

I, certify and acknowledge:

  1. That Steven Oberfest, an independent Personal Trainer, has advised me, prior to my commencement of participation in a cardiovascular and weight training program, that such participation could result in physical injury.
  2. That I freely and knowingly assume the risks in such program and I hereby waive any right, claim or cause of action against Steven Oberfest and release him from any liability for any injury, cost, damage expense, or claim, which I or anyone on my behalf might have as a direct or indirect result of my participation in this cardiovascular and weight training program.
  3. That I have read the foregoing, understand and agree with each of the foregoing and have received a copy of this Release Form on the date described below.

By checking on the signature box below, this indicates that I have accepted all terms stated above and fully understand that this is a substitution for my actual signature.