Momentum Athletic Center Participant Consent and Waiver
Name of Participant
First Name
Last Name
Parent/ Guardian Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Are You Currently an Active Momentum Athletic Center Athlete?
YES
NO
What are you participating in?
Open Play
Parent's Night Out
Clinic
Trial Class or Bring a Friend Event
Birthday Party
Other Event
Continue
Continue
Release and Waiver of Liability and Indemnity Agreement
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In consideration of being permitted to participate in any way in Momentum Athletic Center (“Momentum”) programs (including trainings, demonstrations and other events) and/or being permitted to enter for any purpose any restricted area (herein defined as any area operated by or under MOMENTUM supervision wherein admittance to the general public is prohibited), the (i) participant or (ii) the parent(s) and/or legal guardian(s) of the minor participant named below, agree(s) - EXPAND TO READ ENTIRE DISCLOSURE PRIOR TO SIGNING
Signature of Adult Participant of Legal Guardian*Under penalty of perjury, I herewith affirm that my electronic signature, was signed by myself with full knowledge and consent and am legally bound to these terms and conditions.
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Type a question
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In consideration of participating at FRW, LLC, (Momentum Athletic Center) a Colorado Limited Liability Company, I represent that I understand the nature of this activity and that I am qualified, in good health and in proper physical condition to participate in such activity. I acknowledge that if I believe event conditions are unsafe or I am unable to safely perform any activity, I will immediately discontinue participation in the activity. EXPAND TO READ THE ENTIRE DISCLOSURE PRIOR TO SIGNING.
By signing this waiver, I acknowledge that I have read, understood, and agree to the above statement:
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Parental Consent
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I, hereby covenant and promise that I am the minor’s parent and/or legal guardian, and on behalf of myself and the minor, understand the nature of the above referenced activities and the minor’s experience and capabilities and believe the minor to be qualified to participate in such activity. I further understand therisk of exposure to injury and/or infectious diseases, for myself and my child, as a participant, spectator at events, classes or our presence at the facility. I further acknowledge that if I or the minor view/use any online or digital materials created by or distributed by FRW, LLC, that I am wholly responsible to ensure our safety. EXPAND TO READ THE ENTIRE DISCLOSURE PRIOR TO SIGNING,
Signature
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Should be Empty: