Registration Fitness – TJ PowerFit

Name

First

Last

Birthdate (mm-dd-yyyy)

Dryland Training- TEAM NAME

U18 AA Wildcats
U18 AA Broncos
U13 AA Wildcats
Other

Address

Phone #

Email Address

Emergency Contact Name and Number

Parents/Guardians Name

Please indicate any medical conditions, medications, or allergies:

Release of Liability, Waiver of Claims, Assumptionof Risks and Indemnity Agreement "RELEASE AGREEMENT"

DEFINITION: In this Release Agreement, the term "Power Skating” and "Dryland Training"shall include events or services provided, arranged, organized, conducted, sponsored or authorized by the Releasees and shall include, but not be limited to: games, practices,dryland training sessions, instructional courses, or other events and services in any way connected with or related to Power Skating.
PROTECTIVE EQUIPMENT- Mandatory to wear a helmet and other protective equipment as deemed necessary.
ASSUMPTION OF RISKS- I am aware that Power Skating and Dryland Training activities involve many risks, dangers and hazards. The risks may include negligence of other participants; and NEGLIGENCE ON THE PART OF THE RELEASEES, INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF POWER SKATING. I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH POWER SKATING AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM.
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT In consideration of the RELEASEES agreeing to my participation in Power Skating and Dryland Training, I hereby agree as follows
1. TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the RELEASEES AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer, as a result of my participation in Power Skating and Dryland Training, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, or BREACH OF CONTRACT AND FURTHER INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN POWER SKATING, Dryland or Fitness Training ACTIVITIES REFERRED TO ABOVE;
2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES for any and all liability for any property damage, loss or personal injury to any third party resulting from my participation in Power Skating, Dryland and Fitness Training activities;
3. This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity
4. This Release Agreement and any rights, duties and obligations as between the parties to this Release Agreement shall be governed by and interpreted solely in accordance with the laws of the province where the Power Skating, Dryland and Fitness activities take place and no other jurisdiction; and
5. Any litigation involving the parties to this Release Agreement shall be brought solely within the province where the Power Skating, Dryland and Fitness activities take place and shall be within the exclusive jurisdiction of the Courts of that province.

Photo Release

Should the participant be filmed for teaching purposes, or name/photo published for public display, a signature/ check box granting permission is required .

Release Agreement

In entering into this Release Agreement I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of participating in Power Skating activities, other than what is set forth in this Release Agreement. I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.

Dated (Signed dd/mm/yyyy)

Printed name of Parent/Guardian

Acknowledgement

By checking this box, I confirm that I am the legal Parent/Guardian of the particpant registered in this TJ Power Fit Camp as printed above. I also agree that I have read this waiver, and that by submitting this online Registration Form, this waiver is binding.