CLINIC REGISTRATION
  • OPEN GYM AND EVENT Waiver

    WAIVER
  • Birthdate
     - -
  • Current Grade
  • Format: (000) 000-0000.
  • ELITE CHEER AND ATHLETIC TRAINING LLC

    d/b/a ELITE CHEER
    7 PUZZLE LN, UNIT 1

    NEW GYM
    NEWTON, NH 03858
    978- 341-0020

    MINOR’S RELEASE AND WAIVER OF LIABILITY AGREEMENT

     

  •  

    WHEREAS, ELITE CHEER AND ATHLETIC TRAINING LLC, D/B/A ELITE CHEER
    (“Company”) is the owner and operator of an activity, cheer and tumbling (the “Activity”) and is
    willing to permit the minor individual (the “Child”) on whose behalf the
    parent/guardian/custodian is signing this Agreement to participate in the Activity, upon the terms
    and conditions of this Agreement. All of the Activity shall take place on property controlled by
    the Company. The location of the Activity shall be on property (the “Premises”) located at 7
    Puzzle Ln, Unit 1, Newton, NH 03858. The Company and Participants signing this Agreement
    may be collectively referred to as (the “Parties”).
    In consideration for being provided the ability to participate in the Activity and enter the
    Premises, I, and my minor child, signing below hereby stipulate and agree:
    1. Scope and Continued Application. This Minor’s Release and Waiver of Liability
    Agreement applies to me, the parent or legal guardian signing on behalf of my Child, to my
    Child as a minor, and to my Child when they reach the age of majority or become an adult
    member of Company.
    2. Use of Premises for Activity Only. I understand and agree that my Child may only use the
    Premises for the Activity set forth in this Release and Waiver of Liability agreement. I
    further agree that my Child is responsible for the proper use and care of the Premises and any
    of Company’s property thereon, and that I will be liable for the replacement cost of any
    Company property/equipment which is damaged, destroyed or lost by my Child.
    3. Acknowledgement of Danger. I understand and acknowledge that the Activity my Child
    wants to participate in is extremely strenuous. I recognize and understand these Services are
    not without varying degrees of risk, which may include, but are not limited to the following:
    (1) PHYSICAL INJURY AND/OR DEATH including minor injuries and major injuries such
    as joint and knee/back/foot injuries, broken bones, concussions, rhabdomyolysis,
    musculoskeletal injuries, muscle strains, pull or tears, shin splint, heat exhaustion,
    cardiovascular injuries, heart attack, stroke, and brain injury; (2) exposure to, and sickness
    from, infections viruses, bacteria and disease, including but not limited to, COVID-19; and
    (3) property damage. I understand that the Premises may contain toys or other items that
    other children have brought along with them, and I willingly accept the risk related to these
    objects being around and/or in contact with my Child. I further acknowledge that any injury
    my Child may sustain while participating in the Activity may be compounded by improper

     

  • use or failure of equipment, a known or unknown medical condition, negligent or delayed
    medical service, or negligent or delayed assistance by the Company.
    4. Acceptance of Responsibility. I willingly assume full responsibility for any and all risks
    that I am exposing my Child to as a result of my Child’s participation in any Activity in the
    Premises and training program and accept full responsibility for any injury or death that may
    result from their participation.
    5. Assumption of Risk. Understanding, acknowledging, and accepting all the risks and
    hazards involved with the Services, I freely and voluntarily choose to all my Child to
    participate, enter, and use the Premises, and I, FOR MYSELF AND ON BEHALF OF MY
    CHILD, HEREBY VOLUNTARILY AND EXPRESSLY AGREE TO ACCEPT AND
    ASSUME ALL RISK OF LOSS, DAMAGES, THEFT, INJURY OR DEATH THAT MAY
    OCCUR TO MY CHILD OR THEIR PROPERTY AS A RESULT OF OR INCIDENT TO
    MY CHILD’S PARTICIPATION IN THE SERVICES, INCLUDING THE RISK THEY
    MAY BE INJURED BY THE ACTIONS, OMISSIONS, REPRESENTATIONS OR
    NEGLIGENCE OF THE COMPANY, ITS OWNERS, AGENTS, OFFICERS,
    PRINCIPALS, EMPLOYEES, INDEPENDENT CONTRACTORS, VOLUNTEERS, OR
    ANY OTHER PERSON ASSOCIATED WITH COMPANY (“RELEASED PARTIES”),
    OTHER PARTICIPANTS OR THIRD PARTIES WHILE PARTICIPATING IN THE
    SERVICES OR FROM OR USING OR VISITING THE PREMISES. I understand and
    agree that this Agreement will be binding on me, my spouse (or registered domestic partner),
    my guardians, the executors or administrators of my estate, my heirs, my personal
    representatives, my assigns, my successors in interest, my children, and any guardian ad
    litem for said children (collectively, the “releasors”). I accept full and complete responsibility
    for the safety of myself, any guests, observers or other individuals who I have invited to the
    Premises, and property we have brought to the Premises, and I assume the risk of damage,
    theft, loss or injury caused by others to me, my guests and our property. I also accept full and
    complete responsibility for the consequences of my Child taking unreasonable risks while
    participating in the Services or using the Premises, including, without limitation, attempting
    activities that my Child not qualified to perform safely, causing any other
    participants/spectators an unreasonable risk of harm, or failing to follow correct safety
    procedures when using the Premises and participating in the Services.
    6. Physical Contact Acknowledgement. I understand that the Activity my Child will be
    participating in involves physical contact between my Child, other participants, and those
    presenting Company. I give permission for my Child to be touched in a professional manner
    by coaches and trainers representing the Company and recognize that they will have direct
    contact with my Child when doing so. I acknowledge that it is my responsibility to notify
    Company if I am uncomfortable with this physical contact with my Child and will work with
    Company to determine how my Child may continue to participate in the Activity with no
    contact.
    7. Publicity Release. For good and valuable consideration, the receipt of which is hereby
    acknowledged, I hereby irrevocably grant to Company, the irrevocable, perpetual and

     

  • unrestricted (except as expressly set forth below) right and permission, to use and publish my
    Child’s appearance (“publicity rights”) in any and all media now or hereafter known in
    connection with the Company, the Services, including any goods or products, or any related
    activities to any of the foregoing (all such medium in which the Publicity Rights are used
    shall be referred to as the “pictures”), for any commercial purpose whatsoever, without
    royalty, payment, or any other compensation whatsoever to me or my Child. For such use of
    the Publicity Rights and the Pictures, I understand and agree that I and my Child will not be
    entitled to any compensation or consideration beyond my Child’s participation in the
    Services. I further agree that the Company may edit, alter, digitize, synchronize, reproduce or
    otherwise change the Pictures for any such purpose. I acknowledge that I and my Child shall
    have no, and hereby expressly disclaim, any ownership, authorship or moral rights in the
    Pictures or any part thereof.
    8. Video Surveillance. I recognize the need for video surveillance on and about Premises for
    security and productivity purposes. I recognize and agree that it is a condition of my Child’s
    participation at the Company that I freely execute and agree to this video surveillance,
    including being personally recorded pursuant to said video surveillance. I agree that the
    Released Parties may use any taping of my Child’s image, voice or appearance at any time
    pursuant to said video surveillance at its discretion in the ordinary course of its operations.
    9. Audio/Visual Publicity Waive. I agree to indemnify and hold harmless the Released
    Parties, its agents, successors, and assigns, from any and all claims, demands, actions or
    causes of action, liabilities, costs, dues, sanctions, fees, penalties, or expenses of any sort
    arising from the making of such recordings of my Child and their lawful and appropriate use.
    I further acknowledge that the Company exclusively owns all rights to these recordings
    regardless of the form in which they are produced or used.
    10. Copyrights. The rights granted to the Released Parties herein include, without limitation, all
    rights of every nature whatsoever in connection with use of the Pictures, including without
    limitation all copyrights (and any other intellectual property rights) therein and renewals and
    extensions thereof. I acknowledge and agree that all copyrights and right of every other kind
    relating or pertaining to the Pictures described above are the sole property of the Company
    and I and my Child have no claim to the copyrights (or any other intellectual property rights)
    in the Pictures.
    11. Responsibility for Personal Property. I acknowledge and agree that my Child is fully and
    solely responsible for any of my Child’s property and personal belongings that he/she brings
    onto the Premises or that he/she uses during the Activity, and that the Company will not be
    responsible for or provide any security for his/her property and personal belongings.
    12. No Representations by Company. I acknowledge that Company makes no representation as
    to the condition of the Premises or the safety of the Activity or any equipment either on the

    4

    Premises or used in the Activity. I accept, and my Child shall use, the Premises, and its
    equipment, in its “AS IS” condition. I acknowledge and agree that I am not relying upon any
    representation or statement by the Company or the Company’s employees, agents, sponsors,
    or representatives regarding this agreement or the Premises or Activity, except to the extent
    such representations are expressly set forth in this agreement.
    13. Pets and Other Animals: I do hereby indemnify, defend, and hold harmless Company, its
    owners, agents, officers, principals, employees, independent contractors and volunteers, or
    any other person associated with Company who might be claimed to be liable, whether or not
    herein named, of any and all liability, claims, demands, action or rights of actions, loss,
    expense, attorneys’ fees, costs, judgments, or damages of any kind related to, arising from, or
    in any way connected with, any and all injuries and damages of any and every kind, to both
    person and property, and also any and all injuries and damages that may develop in the
    future, as a result of or in any way relating to any dog or other animal that I, or my Child,
    brings to Company’s Premises.
    (a) I understand that any dog or other animal I, or my Child, bring to Company must have
    all legally required licenses and vaccinations and meet all other local statutory and
    regulatory requirements. I understand that I shall have the ongoing obligation to
    maintain and obtain any updated vaccination or licensing as required by applicable
    statute or regulation.
    (b) I understand that any dog or other animal I, or my Child, bring to the Premises must be
    controlled by a leash which extends no greater than six (6) feet in length and any waste
    products eliminated by such animal shall be promptly and efficiently cleaned up by me
    and deposited in an appropriate sanitary receptacle. My, or my Child’s, animal shall
    not be allowed to interfere with any occupant's reasonable and permitted use and
    enjoyment of Company.
    (c) I understand that Company may prohibit me, or my Child, from bringing a dog or other
    animal to Premises at any time for any reason.
    14. Service Animals: I understand that only dogs trained as service animals, within the
    definition of the Americans with Disabilities Act, to perform tasks or work for a person with
    a disability are permitted at the Premises.
    (a) Service animals must be well-behaved and under control at all times. If the service
    animal is not under control, or behaving inappropriately, I understand that Company
    may ask me to leave. Inappropriate behavior includes showing aggression, being
    disruptive, or not being housebroken. I understand that if the presence of the service
    animal poses a direct threat to the health or safety of others that cannot be mitigated, I
    may be asked to remove the service animal from the premises. I shall be liable for any
    damage or injury to any person or property caused by such animal as a result of my
    negligence or failure to control or properly handle the service animal. I will indemnify,
    defend, and hold harmless Company, and its owners, agents, officers, principals,

    5

    employees, independent contractors and volunteers for any damages, loss, expenses,
    attorneys' fees, costs, judgments or liability which might accrue as the case may be,
    because of the my negligence or failure to control or properly handle the service
    animal.
    15. Consent to Medical Treatment. I understand that the Services that take place on the
    Premises may not be supervised and that the Company does not provide medical services. I
    understand that certain prescribed medications may exacerbate these physiological changes
    and create an even greater risk of physical damage or death to my Child. In connection with
    any injury that my Child may sustain or illness or other medical conditions that my Child
    may experience during their presence at the Company, I authorize and consent for my Child
    to receive any emergency first aid, medication, medical and/or surgical treatment deemed
    necessary by the attending personnel and/or the Released Parties. I acknowledge that the
    Released Parties are under no obligation to provide such medical treatment or services, and
    the Released Parties do not warrant or make any representation concerning the adequacy or
    continuation of such medical services, nor can the Released Parties be deemed responsible or
    held liable for any claims arising out of the provision of such medical services or the failure
    to provide or to continue to provide such medical services. I further authorize the Released
    Parties to execute on my behalf and my Child’s behalf any permission forms, consents or
    other appropriate documents relating to medical attention and to act on my behalf if not able
    or immediately available to do so and the same is urgent as determined in their sole
    discretion. I ACKNOWLEDGE AND AGREE THAT EMERGENCY ASSISTANCE
    AND/OR TREATMENT MAY BE RENDERED BY PERSONS WITH TRAINING OR
    EXPERIENCE WHICH MAY NOT BE ADEQUATE FOR CERTAIN MEDICAL
    SITUATIONS AND/OR THE INJURIES SUSTAINED BY MY CHILD, WHICH
    INJURIES MAY BE COMPOUNDED BY NEGLIGENT FIRST AID OR EMERGENCY
    RESPONSE OF THE RELEASED PARTIES OR OTHER INDIVIDUALS OR MEDICAL
    OR EMERGENCY PERSONNEL AND WAIVE ANY CLAIM IN RESPECT THEREOF. I
    expressly acknowledge that if the Company is located some distance from medical facilities,
    that such distance may exacerbate any injury or condition sustained by my Child. I shall be
    responsible for all costs associated with such medical care and related transportation.
    16. Release from Liability and Waiver. In full consideration of the above mentioned risks and
    hazards and in full consideration of the fact that I am willingly and voluntarily allowing my
    Child to participate in the Services, I HEREBY WAIVE RELEASE AND FOREVER
    DISCHARGE ON MY BEHALF AND MY CHILD’S BEHALF ANY AND ALL CLAIMS
    OR CAUSES OF ACTION, NOW KNOWN OR HEREAFTER KNOWN IN ANY
    JURISDICTION THROUGHOUT THE WORLD, AGAINST THE RELEASED PARTIES,
    INCLUDING, WITHOUT LIMITATION, ANY BODILY INJURY OR DISABILITY,
    ILLNESS OR DISEASE, ACCIDENT, DEATH, FINANCIAL LOSS, PROPERTY LOSS,
    DAMAGE, DESTRUCTION, DELAY, INCONVENIENCE OR OTHER HARM OF
    WHATEVER NATURE THAT MAY BE DIRECTLY OR INDIRECTLY RELATED TO,
    ARISING FROM OR SUSTAINED FROM PARTICIPATION IN THE SERVICES
    AND/OR USE OF THE PREMISES OR ACTIVITIES RELATED THERETO,
    NEGLIGENT FIRST AID OR EMERGENCY RESPONSE OF THE RELEASED PARTIES
    OR OTHER NEGLIGENT ACT OR OMISSION OR BREACH OF ANY EXPRESS OR

    6

    IMPLIED WARRANTY OF ANY RELEASED PARTIES OR OTHERWISE, provided that
    nothing in this Section shall be deemed to release any Released Party from liability arising
    from their own willful or intentional injury to me or my property.
    17. Indemnification: I SHALL INDEMNIFY, DEFEND, AND HOLD HARMLESS THE
    RELEASED PARTIES, JOINTLY AND SEVERALLY, FROM AND AGAINST ANY
    AND ALL CLAIMS, ACTIONS, DEMANDS, RIGHTS, LOSSES, COSTS, DAMAGES,
    EXPENSES, SETTLEMENTS, JUDGMENTS, CAUSES OF ACTION AND LIABILITIES
    OF ANY KIND WHATSOEVER, WHETHER FORESEEN OR UNFORESEEN,
    INCLUDING ATTORNEYS’ FEES, IN LAW OR IN EQUITY, ARISING OUT OF OR
    RESULTING FROM ANY CLAIM RELATED TO MY CHILD’S PARTICIPATION IN
    THE SERVICES, INCLUDING WITHOUT LIMITATION, MY OR MY CHILD’S
    BREACH OF THIS AGREEMENT OR PREMISES RULES AND POLICIES, ANY
    INDIVIDUAL WE INVITE TO THE PREMISES, OR ANY OTHER THIRD PARTY
    CLAIM RELATED TO THE SERVICES.
    18. Covenant Not to Sue. I agree, for myself, my Child, and all my heirs, not to sue the
    Released Parties or initiate or assist in the prosecution of any claim for damages or cause of
    action against the Released Parties which I, my Child, or my heirs may have as a result of
    any personal injury, death or property damage my Child may sustain while on or using the
    Premises or while participating in the Activity.
    19. Transition. Upon reaching the age of majority or becoming an adult member of the Gym,
    my Child assumes all rights, responsibilities, and liabilities associated with their participation
    in cheerleading activities. The terms and conditions of this Agreement shall continue to apply
    to my Child in their individual capacity. My Child, upon reaching the age of majority or
    becoming an adult member, hereby agrees to sign a separate waiver acknowledging their
    understanding of the risks involved and releasing the Gym, its staff, employees, and
    volunteers from any and all liability. This separate waiver shall be signed within thirty (30)
    days of my Child reaching the age of majority or becoming an adult member.
    20. Waiver of Terms. No waiver of any term or right in this Release and Waiver of Liability
    agreement shall be effective unless in writing, signed by an authorized representative of the
    waiving party. The failure of any party to enforce any provision of this agreement shall not
    be construed as a waiver or modification of such provision, or impairment of its right to
    enforce such provision or any other provision of this agreement thereafter.
    21. Survival. Any provision of this Release and Waiver of Liability agreement providing for
    performance by either party after termination of this agreement shall survive such
    termination and shall continue to be effective and enforceable.
    22. Governing Law and Venue. This Release and Waiver of Liability agreement will be
    governed by and interpreted in accordance with the laws of the State of New Hampshire,
    without giving effect to the principles of conflicts of law of such state. I agree that any action

    7

    arising out of this Release and Waiver of Liability agreement must be brought exclusively in
    any state or federal court located in Rockingham County, New Hampshire.
    23. Compliance with Laws. In the performance of the terms of this Release and Waiver of
    Liability agreement and use of the Premises, the parties shall comply with all applicable
    federal, state, regional and local laws, rules and regulations.
    24. Severability. If any provision or portion of this Release and Waiver of Liability agreement
    shall be held by a court of competent jurisdiction to be illegal, invalid, or unenforceable, the
    remaining provisions or portions shall remain in full force and effect.
    25. Entire Agreement; Modification; Binding Effect. This Agreement is the entire agreement
    between the parties with respect to the subject matter hereof and supersedes any prior
    agreement or communications between the parties, whether written, oral, electronic, or
    otherwise. No change, modification, amendment, or addition of or to this agreement shall be
    valid unless in writing and signed by authorized representatives of the parties. This
    agreement shall be binding upon and inure to the benefit of the successors, assigns, and legal
    representatives of the parties.
    26. Parental Consent: I, the undersigned parent or legal guardian of the minor child, have read
    the above and understood the foregoing assumption of risk, and release of liability, and agree
    to its terms on behalf of my child and myself. I understand that by signing below, I am giving
    up substantial rights on behalf of my child and myself.

    I, THE PARENT/GUARDIAN/CUSTODIAN, OF THE MINOR CHILD HEREBY
    ACKNOWLEDGE THAT I HAVE FULLY READ AND UNDERSTAND EACH OF THE
    ABOVE PROVISIONS AND THAT I UNDERSTAND I AM GIVING UP SIGNIFICANT
    LEGAL RIGHTS OF MINE AND MY CHILD’S, INCLUDING THE RIGHT TO SUE THE
    COMPANY. I ACKNOWLEDGE THAT PRIOR TO SIGNING THIS AGREEMENT I HAD
    THE OPPORTUNITY TO CONSULT WITH AN ATTORNEY TO REVIEW THIS
    AGREEMENT. I AM AT LEAST EIGHTEEN (18) YEARS OF AGE AND FULLY
    COMPETENT, AND I EXECUTE THIS AGREEMENT VOLUNTARILY AND FOR
    ADEQUATE CONSIDERATION INTENDING TO BE FULLY BOUND.
    Date:
    Participant’s Signature:
    Legal Guardian’s Signature:

  • Should be Empty: