Parent/Guardian Name
*
First Name
Last Name
Phone #
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email:
*
Relationship to Child
*
Mother
Father
Grandparent
Guardian
Other
Self
Child's Name
*
First Name
Last Name
Please list additional Children in the below box, include First & Last Name.
Please also include D.O.B. for each additional child using the following format, 00/00/0000 and include after each child's name.
Waiver, Release of Liability & Indemnity Agreement
In consideration of participating in or otherwise utilize or observe the facilities, services, equipment programs or activities of Off Season Sports Academy and Fitness LLC for any or all purposes, I hereby agree to release and discharge from liability arising from negligence Off Season Sports Academy and Fitness LLC and its owners, directors, employees, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releases”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:
*
*
*
*
*
*
*
*
Assumption of Risk
*
Assumption of Risk-Exercise
*
Medical Emergencies
*
Payment Policies
*
COVID19 Assumption of Risk
*
By signing this document, I agree that I have read and understood this document and I agree to be bound by its terms.
*
Date
*
MM
DD
YYYY
*
Signature of Parent/Guardian
*
Time
*
Hour
Minute
Second
AM
PM
