Membership Form and Waiver

First NameLast Name

Parent/Guardian Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Student Birthdate

Date

Gender

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact

First NameLast Name

Emergency Contact Phone #

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Fitness Goals

Past/Present Injuries

Exercise/Movements that affect injuries

How did you hear about us?

Referral Member Name

Are you registered with Boxing BC?*

YesNo

BOXING BC MEMBERSHIP

Whizbang Boxing requires all athletes to be registered with Boxing BC for liability purposes. If the student registering is not currently a member of Boxing BC we ask that you go to boxingbc.ca and register for the recreation membership for $30.

If you are going to be competing and/or sparring we ask that you complete the competitive membership which will range from $144 to $165 depending on your age. This requires a medical form to be completed by your family doctor.

Check here if you understand that a Boxing BC Membership is required

WAIVER

Physical exercise can be strenuous and is subject to a risk of injury, Whizbang Boxing Ltd. urges you to obtain a physical examination from a doctor prior to commencing any exercise or training program. You agree that by participating in these physical exercise sessions, group classes and/or personal training sessions, you do so entirely AT YOUR OWN RISK. This includes, without limitations:

The use of all amenities and equipment in the facility and your participation in any activity, class, program, personal training or instruction.
The sudden and unforeseen malfunctioning of any equipment.
Our instruction, training, supervision and/or dietary recommendations.
Physical contact with coaches, trainers and other members participating in the boxing club.
Striking objects and equipment.
Contact, colliding, falling or being struck by coaches, trainers and other members participating.
Executing strenuous and demanding physical techniques.
Vigorous physical exertion, strenuous cardiovascular workouts, rapid movements and quick turns and stops.
Dry land techniques including weights, running, circuit training and stretching.
Extreme weather and temperature conditions which may result heatstroke.
Falling or colliding with the ring, walls, stands, equipment or other members.
Failure to properly use any piece of equipment or from the mechanical failure of any equipment.
Spinal cord injuries that can cause paralysis.
Any misuse of equipment that results in damaged or broken equipment (NeuroTrainer, bags, agility equipment) will have a replacement charge associated

By attending Whizbang Boxing Ltd, you agree that you are voluntarily participating in these activities and premises and assume all risk of injury. You expressly agree to release and discharge Whizbang Boxing Ltd., its owners and/or staff members from any or all claims or causes of action. This waiver and release of liability includes, without limitation, all injuries to you which may occur, regardless of negligence.

If any portion of this release from liability shall be deemed by a court of competent jurisdiction to be valid, then the remainder of this release from liability shall remain enforced and effect and the offending provisions severed here from.

By attending Whizbang Boxing Ltd., you agree to release and hold harmless, Whizbang Boxing Ltd., its owners and its employees, from any loss, liability, claim of bodily injury or property damage, or costs which may arise due to the use of Whizbang Boxing Ltd. equipment and my participation in any programs, as governed by the laws of British Columbia.

You acknowledge that you have carefully read this Waiver and Release and fully understand that this is a RELEASE OF LIABILITY. You agree to voluntarily give up any right that you may otherwise have to bring legal action to Whizbang Boxing Ltd., its owners and/or staff members for negligence and/or any other personal injury or property damage.

Media Consent

I grant Whizbang Boxing Ltd. my permission to use photographs or videos taken during the duration of the Summer Courses at the gym for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content.

Media Consent Agreement*

I agree to the terms and conditions of the Media ConsentI do not agree to the terms and conditions of the Media Consent

Athlete Signature (Or Parent/Guardian if under 18)

Name of Signee

First NameLast Name