Waiver

Is the participant at least 18 years of age?*

Yes
No

Membership*

Member
Non-Member

Type of Waiver*

Programs, Birthdays, Open Gym, Daytime Playtime
Parents' Night Out

Parent or Guardian Name*

First Last

Participant's Name*

First Last

Participant's Date of Birth (MM/DD/YY)*

Phone*

Email*

Allergies, Medications, Special Conditions:

Please tell us anything else we may need to know to keep your child comfortable.

I authorize participation in the following activities.*

Classes
Open Gym
Daytime Playtime
Birthday Parties
Camps & Clinics

Tumbling, Cheerleading, Dance, Gymnastics and Ninja programs are included as curriculum in the activities listed.

Parent Consent to Participate*

I agree to the participation waiver.

Waiver of Liability & Release Form
In consideration of the services of Ocala Athletix, its coaches, owners, employees, and all other persons or entities acting on its behalf, I hereby agree to release and discharge Ocala Athletix, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows: I am fully aware that any activity involving motion, height, or athletic activity creates the possibility of serious injury, illness and/or death. I hereby release Ocala Athletix, including its members, officers, shareholders, agents, and employees, from any liability to my athlete, of the person claiming through him/her, arising from injury or illness to the person or property of my athlete occurring on the premise of Ocala Athletix, including any event sponsored or sanctioned by Ocala Athletix, and/or travel to and from such activities. This release includes but is not limited to any claims of negligence, dangerous condition, latent defect, premises liability, code violation, negligent security, failure to warn, vicarious liability, negligent hiring, negligent supervision, negligent maintenance, or improper/ dangerous equipment; it is intended to be as broad as permissible under Florida Law. I am fully aware of the nature of the activities provided and the possibility of injuries or illness arising from such activities. I further agree to hold harmless, indemnify and defend Ocala Athletix, including its members, officers, shareholders, agents, and employees from any loss, liability, damage, or cost incurred by them due to my athlete on the premises or during any event sponsored or sanctioned by Ocala Athletix. This release is intended to be binding upon the athlete, his/her heirs, assignees, and successor in interest, and anyone claiming by or through him/her. I also attest that all information given is factual. I certify that my athlete is in good mental & physical health and may participate in any Ocala Athletix activities. In case of an emergency requiring medical treatment, the undersigned hereby authorizes Ocala Athletix to seek emergency medical services for my athlete. YOU HAVE A THE RIGHT TO REFUSE TO SIGN THIS FORM, AND "OCALA ATHLETIX" HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. Should Ocala Athletix or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. I certify that I have adequate insurance to cover any injury, illness or damage I or my athlete may cause or suffer while participating, or else I agree to bear the costs of such injury, illness or damage myself. For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby consent to the photographing of my child and the recording of my child's voice and the use of these photographs and/or recordings singularly or in conjunction with other photographs and/or recordings for advertising, publicity, commercial or other business purposes. I understand that the term "photograph" as used herein encompasses both still photographs and motion picture footage. Further, I understand others, with or without the consent of Ocala Athletix, may use and/or reproduce such photographs and recordings. I hereby release Ocala Athletix, and any of its associated or affiliated companies, their directors, officers, agents, employees and customers, and appointed advertising agencies, their directors, officers agents and employees from all claims of every kind on account of such use.

Parent Consent to Participate*

I agree to the participation waiver.

Waiver of Liability & Release Form
In consideration of the services of Ocala Athletix, its coaches, owners, employees, and all other persons or entities acting on its behalf, I hereby agree to release and discharge Ocala Athletix, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows: I am fully aware that any activity involving motion, height, or athletic activity creates the possibility of serious injury, illness and/or death. I hereby release Ocala Athletix, including its members, officers, shareholders, agents, and employees, from any liability to my athlete, of the person claiming through him/her, arising from injury or illness to the person or property of my athlete occurring on the premise of Ocala Athletix, including any event sponsored or sanctioned by Ocala Athletix, and/or travel to and from such activities. This release includes but is not limited to any claims of negligence, dangerous condition, latent defect, premises liability, code violation, negligent security, failure to warn, vicarious liability, negligent hiring, negligent supervision, negligent maintenance, or improper/ dangerous equipment; it is intended to be as broad as permissible under Florida Law. I am fully aware of the nature of the activities provided and the possibility of injuries or illness arising from such activities. I further agree to hold harmless, indemnify and defend Ocala Athletix, including its members, officers, shareholders, agents, and employees from any loss, liability, damage, or cost incurred by them due to my athlete on the premises or during any event sponsored or sanctioned by Ocala Athletix. This release is intended to be binding upon the athlete, his/her heirs, assignees, and successor in interest, and anyone claiming by or through him/her. I also attest that all information given is factual. I certify that my athlete is in good mental & physical health and may participate in any Ocala Athletix activities. In case of an emergency requiring medical treatment, the undersigned hereby authorizes Ocala Athletix to seek emergency medical services for my athlete. YOU HAVE A THE RIGHT TO REFUSE TO SIGN THIS FORM, AND "OCALA ATHLETIX" HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. Should Ocala Athletix or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. I certify that I have adequate insurance to cover any injury, illness or damage I or my athlete may cause or suffer while participating, or else I agree to bear the costs of such injury, illness or damage myself. For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby consent to the photographing of my child and the recording of my child's voice and the use of these photographs and/or recordings singularly or in conjunction with other photographs and/or recordings for advertising, publicity, commercial or other business purposes. I understand that the term "photograph" as used herein encompasses both still photographs and motion picture footage. Further, I understand others, with or without the consent of Ocala Athletix, may use and/or reproduce such photographs and recordings. I hereby release Ocala Athletix, and any of its associated or affiliated companies, their directors, officers, agents, employees and customers, and appointed advertising agencies, their directors, officers agents and employees from all claims of every kind on account of such use.

Signature*

Parent or Guardian's Signature*

CAPTCHA

Waiver and Release of Liability and Hold Harmless Agreement