Acknowledgement & Waiver Form
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What do you wish to achieve at Refuel Academy
Acknowledgement of Risk, Injury & Obligation

I acknowledge that i am undertaking a form of physical activity and that by participating in it I am exposed to certain risk. I acknowledge and understand that whilst participating in such activity:

1. I may be injured

2. Other person participating may cause me injury

3. I may cause injury to another person/persons

4. The condition in which the activity is conducted may vary in intensity

5. I partake the possible risk of and responsibility for any injury, death or damage in property resulting from my participation in the activity

Release and Indemnity

I am participating in the activity at my sole risk and responsibility, I release, Indemnify and hold harmless to Refuel Gym Academy (Refuelaca Pte. Ltd)

Its servants and agents form and against all, and any action or claims which may be made by me/behalf/by other parties for or in respect of or arising out of any, injury, loss, damage or death caused to me or my property whether by negligence, breach of contract or in any way whatsoever. I consent to my image being taken and used and reproduced in any format. I understand that any intellectual property, including copyright and image rights, which arises in the visual image(s) belong to Refuel Gym Academy.


1. Appropriate footwear & attire must be worn at all times while in the gym facility or wherever the class is being held

2. Membership are not refundable; I understand that i hereby undertake this contract during the length of my membership and will pay one month's penalty fee should there be a cancellation under any circumstances.

3. All weights and equipment must be put back after use

4. Photo ID cards (i.e. student card or driver license) must be carried and shown upon request for membership purchases

5. Shared gym access with a non-member will result in forfeiture of membership effective immediately

6. Each member must always respect other gym users and behave in an appropriate manner

I have read and agreed with all of the above and understand that the above applies to all Refuelaca Pte Ltd.

I acknowledge and would like to:

Thanks for submitting!