BODY-Series Teens & Junior Sessions – Parent/Guardian Consent & Waiver

BODY-Series Teens & Junior Sessions – Parent/Guardian Consent & Waiver

Complete this form to give consent for a young person's participation in fitness sessions at The Bodyshop Fitness Centre.
Young Person Details
Young Person Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Session Type

Other
Does the young person have any known medical conditions, injuries, allergies, asthma, medication, or additional needs?
If yes, please provide details
Parent/Guardian Details
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Young Person
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact
Emergency Contact Name

First NameLast Name
Relationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternative Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical & Participation Consent
Please read and confirm each statement before signing.
I confirm I am the parent or legal guardian of the young person named above.
I give permission for the young person to participate in BODY-Series teens and/or junior fitness sessions at The Bodyshop Fitness Centre.
I understand that fitness sessions involve physical activity and carry a risk of injury.
I confirm that, to the best of my knowledge, the young person is fit and able to take part in exercise.
I have disclosed any relevant medical conditions, injuries, allergies, medication, or additional needs.
I agree that the young person must follow coach instructions and gym safety rules at all times.
I understand that coaches may stop the young person from participating if they believe it is unsafe for them to continue.
I agree to inform The Bodyshop Fitness Centre immediately if the young person's health or medical circumstances change.
Emergency Medical Consent
Consent to first aid or emergency medical assistance
Parent/Guardian Consent
Liability Waiver
Liability waiver acknowledgment
Confirmation of release terms
Signature
Parent/Guardian Declaration & Signature
I have read, understood, and agree to the above terms
Parent/Guardian E-Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

BODY-Series Teens & Junior Sessions – Parent/Guardian Consent & Waiver

Young Person Details

Parent/Guardian Details

Emergency Contact

Medical & Participation Consent

Emergency Medical Consent

Liability Waiver

Parent/Guardian Declaration & Signature