Liability Form

LIABILITY FORM
Full Name*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Cell Phone*
Address*

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
State*
Zip*
Camp Location*
1. Photos and videos are regularly taken during workout sessions to be used to inspire others and encourage a healthy lifestyle. All photos and videos are displayed on social media outlets to motivate others to work hard to achieve their goals. As such, do you agree to allow their pictures and videos to be posted to social media outlets.
Initials
Emergency Contact*
Relationship*
Emergency Contact Phone Number*
I agree to hold harmless Travis Garza/TLC Fitness, Garza's Strength and Fitness Factory, Inc./SHK Consulting, LLC., Myosculpt Nutrition LLC and all of his employees or agents free from any and all injuries, losses, damages, and liability occurring from my participation in the activity for which I have enrolled. I also agree to be photographed/videotaped and release the use of the photographs/videos for publicity in Garza’s Strength and Fitness Factory, TLC Fitness, Inc.’s, and SHK Consulting, LLC publications and other marketing tools.

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Date

MonthDayYear
Date
If participant is a minor, then the parent or legal guardian needs to sign below.

Clear
Date

MonthDayYear
Date
Should be Empty:

LIABILITY FORM