Combine Intake and Registration Form

Combine Intake and Registration Form
IMPORTANT NOTICE!!

Please note that, in order to confirm your registration for this event, we must receive your e-transfer payment. Please send your e-transfer to combineperformance@gmail.com. Once we receive your e-transfer, we will email you a registration confirmation. Please note that if payment is not received within 24 hours of registration, we will send a reminder email. If the event reaches capacity before payment is received, your spot may be offered to the next athlete on the registration list.Thank you for your understanding, and we look forward to seeing you at the event!
Early Bird Pricing in Effect! $35

If you are seeing this, this means you're eligible for the early bird pricing!
Full Name of Athlete

First NameLast Name
Birth Date of Athlete

MonthDayYear
Date
Athletes Email
example@example.com
Full Name of Parent or Guardian if athlete is under the age of 18

First NameLast Name
Parent or Guardians Email
example@example.com
Phone Number of Parent or Guardian
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please choose your preferred start time (spots are limited to 10 per slot)
Does the athlete have any previous or recent injuries? If previous, how long ago.
If none, please indicated to N/A
Does the athlete have any current medical conditions?
If none, please indicated to N/A
Is there a family history of any medical conditions (All are considered, not just serious ones).
If none, please indicated to N/A
Has the athlete been hospitalized at all in the last 3-6 months? If so, what for.
If not, please indicated with N/A
Waiver, Release of Liability, and Assumption of Risk Agreement

This Waiver and Release of Liability (“Agreement”) is entered into by and between Game Speed and Geared Performance (“Organizer”) and the undersigned participant (“Participant”) as a condition of participation in the Speed Combine (“Event”).
Name of Athlete

First NameLast Name
1. Acknowledgment of Risk
I, the undersigned, acknowledge and fully understand that participation in athletic training, conditioning, and speed performance testing involves inherent risks, including but not limited to:
- Muscle strains, sprains, or tears
- Joint or ligament injuries
- Cardiovascular stress, fainting, or exhaustion
- Slips, trips, and falls
- Other physical injury, permanent disability, or in rare cases, death
I understand these risks are inherent to athletic activity, may be caused by my own actions or inactions, the actions or inactions of others, or the conditions of the premises and equipment.

2. Assumption of Risk
I voluntarily choose to participate in the Event and expressly assume all risks of injury, illness, disability, or death arising from participation, whether foreseen or unforeseen, and regardless of cause.

3. Release of Liability
In consideration for being permitted to participate in the Event, I hereby release, waive, and discharge Game Speed and Geared Performance, its officers, directors, employees, volunteers, contractors, agents, and affiliates (“Released Parties”) from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss, damage, or injury (including death) that may be sustained by me while participating in or related to the Event, including those caused by the negligence of the Released Parties.

4. Indemnification
I agree to indemnify, defend, and hold harmless the Released Parties from any loss, liability, damage, or costs (including attorney’s fees) incurred as a result of my participation in the Event.

5. Participant Responsibility
I understand that I am solely responsible for monitoring my physical condition and exercising within my own limits. I agree to immediately notify a coach, trainer, or Event staff member if I experience any pain, discomfort, or health concerns.

I further acknowledge that while the Organizer will make reasonable efforts to promote safety, the Organizer is not responsible for ensuring my personal safety and cannot eliminate all risks associated with athletic participation.

6. Medical Authorization
In the event of an emergency, I authorize the Organizer to secure medical treatment deemed necessary and agree to be financially responsible for any related costs.

7. Governing Law
This Agreement shall be governed by and construed in accordance with the laws of the Province of Ontario.

8. Severability
If any provision of this Agreement is found to be unenforceable, the remaining provisions shall remain in full force and effect.

9. Acknowledgment of Understanding
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I AM GIVING UP LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. I SIGN THIS AGREEMENT FREELY AND VOLUNTARILY.
Athletes Signature. By Signing your name below you agree to all the terms and agreements listed above.
Parent or Guardian's Signature. By Signing your name below on behalf of the athlete that is under the age of 18, you agree to all the terms and agreements listed above (N/A of athlete is above the age of 18).

Social Media Release Form

Scope of Use

The Media may be used for:

Social Media Platforms: Including but not limited to Facebook, Instagram, Twitter, TikTok, YouTube, LinkedIn, and other similar platforms.
Promotional Content: Posts, advertisements, stories, and reels.
Duration: This release remains valid indefinitely unless I revoke my consent in writing (see Revocation of Consent).

Consent Terms
Voluntary Participation: I confirm that my participation is voluntary, and I have not been compensated or coerced into consenting to this release.
No Expectation of Privacy: I understand that the Media will be publicly accessible and that the Organization cannot control third-party use once the Media is posted.
No Financial Claim: I waive any right to financial compensation for the use of the Media.
Editing Rights: I grant the Organization the right to edit, alter, or combine the Media with other content as deemed necessary, provided it does not misrepresent me.

Revocation of Consent
I understand that I may revoke this consent at any time by providing written notice to the Organization. Upon receipt of such notice, the Organization will cease using my Media for new content. However, previously posted content may remain online.

Release of Liability
I release and hold harmless Geared Performance, its employees, agents, and representatives from any claims, demands, or liabilities arising out of or related to the use of the Media.

Acknowledgment and Agreement
By signing below, I confirm that:

I am at least 18 years old or have obtained consent from a legal guardian.
I have read and understood this Social Media Release Form.
I agree to the terms outlined above.
Signature of Athlete
Signature of Parent of Guardian
Full Name of Athlete

First NameLast Name
Full Name of Parent or Legal Guardian

First NameLast Name
Providing your signature belows states that I, (Name of Athlete and Parent or Legal Guardian Identified above), hereby grant Liam Birkwood, Derek Shore and their companies Geared Performance, and Game Speed permission to use my image, likeness, voice, and/or statements (collectively referred to as "Media") captured through photographs, videos, or other recordings, for the purposes of social media posts and related online content and advertisment.
Signature of Athlete
Signature of Parent or Legal Guardian
Should be Empty:

Combine Intake and Registration Form

IMPORTANT NOTICE!!

Early Bird Pricing in Effect! $35