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Students entered below will be added to your family's account
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Omni Waiver
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Liability Release: For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I ___________________________________, as a parent or legal guardian of _________________________________, a minor (hereinafter “Minor”), hereby grant the permission necessary to allow Minor to participate in the above practice, class, camp or event to be conducted by Omni Elite Athletix, LLC or Omni Elite Foundation. I, in my own behalf and/or on behalf of the Minor, further agree to release and to hold harmless Omni Elite Athletix, LLC, Omni Elite Foundation and Corporate Sponsors (hereinafter “Sponsors”), Housing Sites (Omni Elite Athletix gym, university, hotel, convention center, high school) on whose premise the practice, camp, class or event will occur (hereinafter “Location”) the affiliates of Omni Elite Athletix, LLC or Omni Elite Foundation, the location and the respective directors, officers, representatives, members, agents, and employees of Omni Elite Athletix, LLC, Omni Elite Foundation, sponsors, the location and their respective affiliates (hereinafter collectively “Releases”) from any and all liability, whether caused by negligence of the Releasees or otherwise for any claim , judgement, loss, liability, cost and expense (including, without limitations, attorney’s fees and costs) arising out of or connected with any activity or event, including any claim arising out of or connected to any illness or injury (minimal, serious, catastrophic, and/or death) the Participant and/or a Minor may incur or sustain during a practice, class, camp, or event and all activities associated while traveling to and from the site whether or not the activity or event actually occurs. I further expressly agree to indemnify and hold harmless Releases and Releases' heirs, successors, assigns, executors and administrators against loss from any further claims, demands or actions that may subsequently be brought by the Participant or Minor or by any other persons on the account of damages of any character resulting to Participant or Minor in anyway from the forgoing activities. I further agree to reimburse and make good to Release any loss of costs Releases may have to pay as a result of such action , claim or demand. I hereby warrant that I have read this Liability Release in its entirety and fully understand its content. I am aware that this Liability Release releases Releases from liability and contains and acknowledgement of my voluntary knowing assumption of risk of injury or illness. I further acknowledge that nothing in this Liability Release constitutes a guarantee that the Practice, Class, Camp or Event will occur.I have signed this document voluntarily and of my own free will. Signature X_________________________________________________________________ Date __________________________ Medical Release: I, In my own behalf as participant and/or on behalf of the Minor, acknowledge and agree that such participation subjects Minor and/or Participant to the possibility of physical illness or injury (minimal, serious, catastrophic and/or death) and that I, in my own behalf of Participant and/or on behalf of the Minor, acknowledge that the participant or minor is assuming such risk of Illness, or injury by participating in the practice, class, camp or event. In the event of such illness or injury, I authorize Omni Elite Athletix, LLC and Omni Elite Foundation to obtain necessary medical treatment of Minor and hereby, in my own behalf and/or on behalf of the Minor, release and hold harmless Releases in the exercises of this authority. I further acknowledge and understand that I will be responsible for any and all medical and related bills that may be incurred on behalf of the myself (the Participant) or Minor for any illness or injury that the Participant or Minor may sustain during the Practice, Class, Camp or Event and while traveling to and from the site for the Practice, Class, Camp or Event whether
I've read the above and agree.
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Credit Card Verification: |
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Name as it appears on card: * |
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Card Expiration Month: * |
Exp Year: *
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Zip:*
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