Your Name: Email:
Date of Birth: ---January FebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember ---01020304050607080910111213141516171819202122232425262728293031,
Cell Phone # :
In an emergency, I would like LETS CrossFit to call the proper emergency personnel and Phone #
Do you smoke? yes no
Drink Alcohol? yes no
Take Prescription Meds? yes no
Are you exercising now? yes no
How many days per week? 01234567
Do you play sports? yes no
Do you have pain? yes no
Where? back knee shoulder other
Previous injuries or surgeries? yes no
Please indicate conditions you have: asthma diabetes a heart condition
Any other health conditions not listed?
Participants involved in any activities offered by LETS CrossFit may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the LETS CrossFit website or in any editorial, promotional or advertising produced and/or published by LETS CrossFit.
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 might 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 LETS CrossFit. I acknowledge that I have no physical impairments, injuries, or illnesses that will endanger others or me.
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 LETS CrossFit, I, the undersigned hereby release LETS CrossFit, 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 successors, my representatives, heirs, executors, assigns, transferees, or me. 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 LETS CrossFit to administer first aid deemed necessary, and in any 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 LETS CrossFit. Therefore the participant accents 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 LETS CrossFit, 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 the activities offered by LETS CrossFit, 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 LETS CrossFit. 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 cause by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.
Ready for some pain and gain? Bring everything you've got because we are going to push it! Don't forget to log those times and check your profile to track your progress. LETS go!
Run 500m For time
30 sit-ups for time
Find Your 1 RM Dead Lift
21-15-9 reps of
Squat Clean (95/65lbs)
Box Jumps ( 24/20”)
Run 200m / 100 single jumps / 40 double unders
Find your max 5 rep Full Snatch
5 Rounds for reps
In 2 minutes complete
3 rounds of:
Row 100m fast
Row 100m relaxed
30 Turkish Getups total
15 KB Swings @ 1/1.5pood
2 for 1 wall balls x 10
5 ring dips