Boxing School Registration & Liability Release

Participant Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Home Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Date of Birth

Date

Preferred Method of Contact

Do you have any medical conditions or allergies?

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Grand Valley Boxing Club: Boxing/Fitness Waiver/Release FormFor and in consideration of Grand Valley Boxing Club permitting the participant to enroll and participate in a boxing/fitness training class(es). Participant by signing below, voluntarily releases from liability, indemnifies, and holds harmless Grand Valley Boxing Club and its owners, officers, directors, employees, affiliates and advisors and the facilities (collectively, 'Grand Valley Boxing Club') from and for any accident, injury, illness, death, loss, damage to person or property or other consequences suffered by Participant or any other person arising or resulting directly or indirectly from Participant's participation in the boxing/fitness training class(es). In the event that the Participant is injured, Participant agrees to assume any financial obligation, either through Participant's personal health insurance, or through some other means, for any medical costs which Participant incurs. Grand Valley Boxing Club assumes no responsibility for any medical expenses, injury, or damage suffered by Participant in connection with the use of the facilities, equipment or services in connection with the boxing/fitness training class(es).IT IS THE INTENTION OF PARTICIPANT BY SIGNING BELOW TO EXPRESSLY ASSUME ALL RISK OF PERSONAL INJURY, DEATH, OR PROPERTY DAMAGE UPON HIM/HERSELF, TO THE EXCLUSION OF GRAND VALLEY BOXING CLUB AND TO EXEMPT AND RELIEVE GRAND VALLEY BOXING CLUB FROM LIABILITY FOR ANY & ALL PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH.Participant further agrees that Participant, his/her spouse, assignees, heirs, guardians, and legal representatives will not make any claim against, sue or attach Grand Valley Boxing Club for any loss or damage resulting from Participant's participation in the boxing/fitness training class(es) or use of the facilities, equipment or services.PARTICIPANT IS AWARE THAT HE OR SHE WILL BE ENGAGING IN A RANGE OF ACTIVITIES INCLUDING, BUT NOT LIMITED TO, JUMPING, STRETCHING, TURNING, LIFTING, PUNCHING AND TWISTING. PARTICIPANT IS AWARE OF THE POTENTIAL DANGERS INCIDENTAL TO ENGAGING IN BOXING/FITNESS ACTIVITIES WHICH INCLUDE BUT ARE NOT LIMITED TO STRAINS, SPRAINS, TEARS, AND BROKEN BONES. PARTICIPANT AGREES THAT THIS IS A RELEASE OF LIABILITY, A WAIVER OF THE PARTICIPANT'S LEGAL RIGHT TO COLLECT DAMAGES IN THE EVENT OF INJURY, DEATH OR PROPERTY DAMAGE AND A CONTRACT BETWEEN PARTICIPANT AND TEAM GRAND VALLEY BOXING CLUB AND PARTICIPANT SIGNS IT OF HIS/HER OWN FREE WILL.

I have read and agree to the terms of the release from liability.

Signature of Parent or Legal Guardian (if participant is under 18):

Date of Signature (Parent or Legal Guardian)

Date