Liability and Media Waiver Form

Liability and Media Waiver Form

Please complete this form to acknowledge risks, waive liability, and consent to media usage at The Grind Lab Tampa.
Participant Full Name*

First NameLast Name
Participant Email Address*
example@example.com
Participant Phone Number*

Area CodePhone Number
Emergency Contact Full Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Acknowledgment of Risks: I acknowledge that participation in activities at The Grind Lab Tampa involves inherent risks, including but not limited to physical injury, and I voluntarily assume all such risks.*

I have read and understand the risks involved and voluntarily accept them.
Waiver of Liability: I hereby release and hold harmless The Grind Lab Tampa, its owners, staff, and affiliates from any and all liability, claims, or demands resulting from my participation.*

I agree to the waiver of liability as stated above.
Consent for Media Usage: I grant permission for The Grind Lab Tampa to use photographs and/or videos of me taken during participation for promotional or educational purposes, without compensation.*

I consent to the use of my photos/videos as described above.
By typing my name below, I understand and agree that this acts as my electronic signature and is legally binding.*
Date Signed*

MonthDayYear
Date
Should be Empty: