Sign Form
SUMMER FITNESS CAMP
EMS-ISD JUNIOR & HIGH SCHOOL BAND & COLORGUARD STUDENTS
Student Name
First Name
Last Name
School & Grade level
Student ID #
Parent Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Select which week(s) your student will participate.
Week 1 July 7 - 11
Week 2 July 14 - 18
Please list any pre-existing health conditions we should be made aware of
Additional Emergency Contact
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Fitness Class Disclaimer - Band Health & Fitness by Anthony Azizi
Fitness Class Disclaimer – Band Health & Fitness by Anthony Azizi PLEASE READ THIS DISCLAIMER CAREFULLY BEFORE PARTICIPATING IN ANY FITNESS CLASS OR ACTIVITY. By participating in the fitness classes or activities offered by Anthony Azizi, you agree to the following terms and conditions: 1. 2. 3. 4. 5. 6. 7. 8. Assumption of Risk: You acknowledge that participation in fitness classes and exercises involves inherent risks and dangers, including the risk of personal injury or health-related issues. You assume full responsibility for these risks and agree to participate at your own risk. Health Statement: You confirm that you are in good health and physically capable of participating in the fitness classes or activities. If you have any pre-existing medical conditions or concerns, you must consult with a healthcare provider before participation. Professional Guidance: You acknowledge that it is advisable to seek professional medical advice if you have any doubts about your ability to safely participate in the classes. If needed, you should follow the guidance and restrictions set by your healthcare provider. Proper Use of Equipment: You agree to use any equipment provided by Antony Azizi in the manner intended and follow all instructions provided by the instructors or staff. Failure to do so may increase the risk of injury. Waiver of Liability: You agree to waive, release, and discharge Anthony Azizi, and affiliates from any claims, liabilities, or demands that may arise from your participation in the classes, including any claims related to personal injury or loss of property, whether caused by negligence or otherwise. Consent to Medical Treatment: You consent to receive medical treatment in the event of injury, accident, or illness during any fitness activity, and you agree to be financially responsible for the cost of any such treatment. Changes and Cancellations: You understand that Anthony Azizi reserves the right to change or cancel classes, instructors, or schedules at any time, and no refunds will be provided for any such changes. Media Consent: You agree that Anthony Azizi may take photographs or videos during the class for promotional purposes and consent to the use of your likeness in such media. Acknowledgement and Agreement
Signature
*
I have read and understood the above Fitness Class disclaimer and agree to all conditions set forth. By signing, I voluntarily agree to participate in the fitness classes or activities offered by Band Health and Fitness by Anthony Azizi
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