Waiver Form

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Waiver Form

StrengthFlex – Liability Waiver

Child's Frist Name:*

Child's Last Name*

Child's Date of Birth*

day

/

month

/

year

Is our child a dancer or an athlete?*

Dancer

Athlete

What studio child is attending?*

Your Email*

Phone:*

Your Street Address*

Apt. Suite, etc.

City*

State*

Zip Code*

I declare that the info I've provided is accurate and complete*

Yes

Risk: I acknowledge that participation at StrengthFlex Athletics entails known and unknown risk that could result in physical or emotion injury, broken bones, paralysis, or death Release: I hereby agree that myself or my child, adopted or otherwise, my heir or executors, waive and release all rights and claims that I may hove at any time against StrengthFlex Athletics or its representative whether paid or volunteer, for any injury or damages in connection with the activities offered. if you or your child is injured, and may require medical assistance, at your own expense. I expressly agree and promise to accept all risk existing in this activity. My participation or my child/ word participation in this activity is purely voluntary, and I elect to participate in spite of the risks. I give permission for my child to be videoed and photographed for advertising purpose. *

I understand the risks

By printing my name I agree to the terms and conditions*

Contact Info

Email:
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Address:
947 W Duarte Rd, Monrovia, CA 91016

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