Waiver Form

Athlete Information

Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Guardian Information

Are you 18 or older? *

Guardian Name *

First

Last

Guardian Email *

Guardian Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

FITNESS RELEASE, WAIVER, AND DISCLAIMER

I hereby give permission for my child/children to participate in performance/sports training conducted at IG Sports Academy. I understand that it is my responsibility to carry my own accident and medical insurance. I have been forewarned that IG Sports Academy will not provide any medical treatment, transportation, or emergency medical services. Notwithstanding, in the event of an injury or accident, I authorize IG Sports Academy to summon professional medical personnel to provide customary medical treatment, as well as transportation and emergency medical services, if warranted, at the sole expense of myself or my health insurance. My child/children is/are physically sound and have medical approval to proceed with a normal exercise routine. My child/children/are in good health and have no physical conditions that would be aggravated by my child’s/children’s participation in the performance/sports training conducted at IG Sports Academy. IG Sports Academy relies upon these representations in entering into this contract and providing training services to my child/children. I acknowledge that the activities my child/children will be participating in at IG Sports Academy may be dangerous and involve many risks of injury such as, but not limited, to death, neck or spine injury, brain damage, and injury to bones, muscles, and other aspects of the body. I do hereby fully and voluntarily assume all risk of loss, damage, or injury that may result therefrom. I, the undersigned, agree to hold IG Sports Academy, its members, managers, staff, and personnel harmless from any liability, causes of action, debts, claims, demands, cost, and expense (including attorneys’ fees and legal costs) in connection with any claim which is inconsistent with any agreement, covenant, representation, or warranty made herein, or which may arise in connection with my child’s/children’s participation in performance/sports training conducted at IG Sports Academy. Children and parents are not allowed in the gym without an IG Sports Academy instructor.

CONSENT TO PHOTOGRAPH/VIDEO RECORDING

I hereby authorize IG Sports Academy to use pictures and video recordings taken of my child/children solely for promotional purposes, including, but not limited to, inclusion on the IG Sports Academy website, social media channels, and brochures, as well as other public media outlets such as local newspapers and periodicals. I reserve the right to revoke this consent at any time upon written notice to IG Sports Academy.

Date *

Waiver Form

Athlete Information

Guardian Information

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