Inspiration Tennis Academy Registration Form

1. Athlete's Name*

First NameLast Name

Date of Birth

Start Date at Inspiration Academy

Date

What is your UTR rating? blanks

What is your WTN Rating blanks

Do you Require Boarding?

Athlete's Cell Number (n/a if not applicable)

Please enter a valid phone number.

If your Athlete require boarding and shuttle service to and from the airport, please include their flight information. We pick up from Bradenton/Sarasota International Airport or Tampa International Airport. (N/A if not applicable)

Athlete's Shirt Size (please indicate youth or adult)

Details of any dietary restrictions or specific diet plan. (N/A if this does not apply)

Training Experience:

Personal Goals for your time with us:

I am coachable, willing to work hard and have a good attitude.

YesNo

Parent or Guardian's Full Name (your name if over 18)

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent or Guradian's Cell Number

Please enter a valid phone number.

Email

example@example.com

Current Medications & Suppliments

Does your Athlete have any food, skin or pet allergies? Please list all that apply or N/A

Does your Athlete currently have a medical conditions, injury or reoccurring injury we should be made aware of? If so, please explain:

Current Medications & Suppliments*Please list any medications and/or supplements being taken. Include medication name, purpose, dose, and times.

Family Physician's Name

Family Physician's Contact Information

Covid-19 Policy Agreement & Waiver*. I voluntarily assume the risk of allowing my child to participate in Inspiration Academy’s on-campus classroom learning. I voluntarily agree to assume all risks and accept sole responsibility for any illness, including but not limited to Covid-19. On behalf of myself, my child, and any successor guardian of my child, I hereby release, covenant not to sue, and agree to hold harmless 21st Century Ministries Inc. DBA Inspiration Academy, its Board Members, employees, agents, insurers, and representatives for any and all claims, liabilities, harm, damages, costs, or expenses related to any illness, including the contraction of COVID-19. By signing this Agreement, I acknowledge that I have read Inspiration Academy’s Covid-19 Response Re-Opening Plan fully and understand the contents of the Waiver. I acknowledge the risks associated with attending Inspiration Academy and the possible contraction of COVID-19 or other communicable diseases.

I Agree

Medical Treatment Release: I request that in my absence the above-named participant be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the above participant.

I agreeI Disagree

Medication Release: I hereby give Inspiration Academy permission to administer over the counter medications or external preparations, in accordance with the directions of use on the container as needed. I here by release Inspiration Academy, its officers, employees, and representatives from all liability in any way resulting or arising from the administering of these medications.

I agreeI disagree

Waiver, Indemnity & Assumption of Risk Agreement: In consideration of Clairebear Properties, LLC d/b/a Inspiration Academy (hereinafter “Academy”) permitting my child (hereinafter “Child”) to participate in physical activities including but not limited to exercise, competitive sports, recreational sports, weight lifting, fitness training, conditioning and nutritional instruction (collectively referred to as “Programs”), on behalf of myself, my heirs, personal representatives, or assigns, I assume all risks and hereby release, waive, discharge, and covenant not to sue the ACADEMY, its employees, volunteers, agents and contractors, from liability from any and all claims arising from or relating to my child’s participation in the Programs. I understand that the ACADEMY services are not a substitute for professional medical advice or a medical examination. Prior to permitting myself or my Child to participate in any ACADEMY program, activity, or exercise, I will seek the advice of a pediatrician or another health-care professional. I understand that exercise and physical activity provides certain health benefits for children, but can also cause unknown health issues and therefore should be done in moderation. I understand that equipment commonly associated with physical fitness may be present at the site where the Programs take place, and that the presence of such equipment could result in an injury to myself or my Child. By allowing myself or my Child to participate in the Programs or any activity associated with the ACADEMY, I agree that the ACADEMY shall not be liable for any direct, indirect, special, consequential, or exemplary damages for any injury or harm to me or my Child incurred in or around the property where exercise occurs. I agree to hold harmless and indemnify the ACADEMY, its employees, volunteers, agents, contractors and insurance carriers from all claims (whether initiated by me or by a third party) and to reimburse them for any expenses incurred because of myself or my Child’s participation in the Programs and other ACADEMY activities. I further agree to pay all expenses, including court costs and attorneys’ fees, incurred by the ACADEMY and the parties in investigating and defending a claim or suit resulting from myself or my Child’s participation in ACADEMY programs. I further expressly agree that the foregoing waiver, indemnity and assumption of risk agreement is intended to be as broad and inclusive as is permitted by the laws of Florida, and that if any portion thereof is held invalid, it is agreed that the balance shall continue in full legal force and effect. I also agree that if legal action is brought, it must be brought in Manatee County, Florida. I have read and agree to the terms of the policy.

I AgreeI Disagree

Photography & Video Release:Many photographs and video are captured at the ACADEMY to be used in the promotion of the ACADEMY. Marketing materials including print brochures, promotional videos, website or any other communications may be published, posted online or shared publicly with the intent to promote the ACADEMY. I further release and discharge the ACADEMY, its successors and assigns, its officers, employees and agents, and the members of the Board of Directors, from all claims and demands arising out of or about the use of such photographs, film or tape, including, but not limited to, any claims for defamation or invasion of privacy. Acknowledgment of Understanding: I have read this waiver of liability, indemnification, and assumption of risk agreement and fully understand its terms. I understand that I am giving up substantial rights ON BEHALF OF MYSELF AND MY CHILD, including THE RIGHT to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be bound hereby. By signing below, I assert that I am the person named above or parent or legal guardian of the Child named above. I have read and agree to the terms of the policy.

My Student Athlete may be photographed & video recordedMy student Athlete may NOT be photographed or video recorded

Parent or Guardian's Full Name

First NameLast Name

My Products

1 Month Full-Time Tennis Academy

! month (4 weeks) of full-time (2 sessions per day) training at Inspiration Tennis Academy.

$2,500.00 Quantity

Monthly Boarding

$2,000.00 Quantity

1 Month Half Day Tennis Academy

1 Month (4 weeks) Half Day (1 session) Tennis Academy.

$1,500.00 Quantity

Weekly Camp (Fall, Winter, Spring & Summer)

(-10% Early Registration Active, $898.00)

$898.00 Quantity

Weekly Boarding

Weekly boarding includes pick-up and drop-off to Tampa International Airport or Sarasota/Bradenton Airport.

$500.00 Quantity

1 Full Day (2 sessions) Drop-In

$165.00 Quantity

1 Half Day (1 Session) Drop-In

$90.00 Quantity

Tour and Experience Inspiration Academy

$ Free Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature

Inspiration Academy is a Non-profit organization, because of this, all payments are final. Though the Payment is final, it is transferable to a later date or sibling.

I Understand

Tennis Registration Form

Welcome to Inspiration Academy. We're excited to have you join our High-Performance Tennis Academy. This Registration includes our Liability Release Waiver and payment options. It's a bit lengthy, but we'll get through it together ;-) (Please fill out for each Student Athlete)

Waiver & Release Form