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RELEASE FORM
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Parent / Guardian Information
Parent / Guardian Name
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Athlete Information
Child's Name
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Last
Date of Birth
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AUTHORIZATION AND RELEASE
Authorization and Release
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I/we understand that by participating at Champion Athletix, Inc. and or by joining Champion Athletix Inc., either on a team, classes, individual or any other activities/participation, there is a possibility of injury to my daughter/son. With this understanding, I give my child permission to participate and attend any activities held at Champion Athletix, Inc.
I/we the undersigned parents/legal guardians agree to forever release the Champion Athletix, Inc. owners, Board of Directors, coaches, employees and volunteers from any claims, actions, right of action, damages, costs, loss of service, expenses, compensations and attorney’s fees that may have risen in the past, or arise from the future, directly or indirectly from known or unknown personal injuries due to participation in any and all programs, classes, or activities associated with or at Champion Athletix, Inc. We further release against any and all legal claims and proceedings of any description that may have been asserted in the past, or may be asserted in the future, directly or indirectly, including damages, costs and attorney’s fees arising from my child’s participation with Champion Athletix, Inc. in the gym or while participating in activities. I/we further confirm that we have read this consent and release liabilities and that I/we understand the contents of this agreement. I/we understand that my child’s participation in this event is voluntary and that participants are free to not participate in Champion Athletix, Inc. programs/events. I/we understand that if I/we do not follow all the rules set forth by Champion Athletix, Inc. owners, coaches and staff, that my child’s membership from Champion Athletix, Inc. may be terminated. I understand that being involved in any activities at Champion Athletix, Inc. that my child’s photo and/or may appear in advertisements, flyers, videos and/or the Champion Athletix, Inc. website or social media sites. I understand that Full names will be omitted.
I agree to the statement above.
Please list any physical/psychological limitations, injuries or weakness that may affect the athlete.
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