MadKatz Boxing
Please complete this form to get started!
Name:
*
First Name
Last Name
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Date of Birth:
*
-
Month
-
Day
Year
Date
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have any previous boxing experience? (optional)
Please select a program:
*
Fitness & Development (Morning)
Fitness & Development (Evening)
Fight Team
Kids & Youth
Women's Only
Personal Training
Open Gym Membership
Open Gym Add-on (+$15/month)
Muay Thai
Name of Emergency Contact:
*
First Name
Last Name
Phone Number of Emergency Contact:
*
Please enter a valid phone number.
RELEASE OF LIABILITY: I hereby understand and acknowledge that the training, programs and events held by MadKatz Boxing in Kelowna, BC may expose me to many inherent risks, including accidents, injury, illness, or even death. I assume all risk of injuries associated with participation including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, and all other such risks being known and appreciated by me. I hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in activity. I acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in. After having read this waiver and knowing these facts, and in consideration of acceptance of my participation and MadKatz Boxing furnishing services to me, I agree, for myself and anyone entitled to act on my behalf, to HOLD HARMLESS, WAIVE AND RELEASE MadKatz Boxing, its officers, agents, employees, organizers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in MadKatz Boxing training, programs and/or events. By my signature I indicate that I have read and understand this Waiver of Liability. I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.
*
Accept
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Youth Waiver
If you are over 18 years of age, please disregard this section, if you are under 18 years of age, this section MUST be completed by your legal guardian to be named below.
Name of Legal Guardian
First Name
Last Name
Phone Number of Legal Guardian
Please enter a valid phone number.
you agree that you are aware that the child named on page one will be engaging in physical exercise involving various sports, coordination, events, and general fitness training, which could cause injury to them. The location of these activities will take place at MadKatz Boxing in Kelowna, BC. You understand that the child is voluntarily participating in these activities and is assuming all risks of injury that may result from engaging in any exercise program or sport related event including tripping, slipping, or falling. You hereby agree to waive any claims or right that you might otherwise have to sue MadKatz Boxing, the center, our employees, owners, officers, or agents for any injury that might occur. You understand that we will make no evaluation or recommendation as to whether or not the child is capable or deemed physically fit to engage in any activity. It is recommended that you consult a physician or your pediatrician prior to your child participating in any physical exercise program.
Accept
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