|
Students entered below will be added to your family's account
|
|
Participation Waiver
(Show-Hide Details)
PARTICIPATION RELEASE In consideration of being allowed to participate in any way at KIDZONE, Inc. athletic/ gymnastic/ sports programs, related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and 2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of staff employees, agents, and representatives of KIDZONE, Inc. or others and assume full responsibility for my participation or that of my minor child or ward for whom I am signing for as legal guardian of a minor; and 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I may remove myself or a minor who I have signed for from participation and bring such to the immediate attention of nearest staff employee; and 4. I, for myself, or my minor child/ward and on behalf of my heirs, assigned, personal representatives and next of kin, herby release and hold harmless KIDZONE, Inc., their officers, staff employees, agents, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of said premise used to conduct the event, (collectively the releasees”), with respect to any and all injury disability, death or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise. 5. This is to certify that I, with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the releasees, and, for myself, any heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the releasees from any and all liabilities incident to the involvement or participation of my minor child in these programs as provided above. I agree to this even if injury or death arises from the negligence of the releasees. This release is absolute and to the fullest extent permitted by law. I further certify that I have health insurance coverage on myself, or my minor child/ward, and the coverage will remain in full force and effect during the period I, or my child/ward remains enrolled with KIDZONE, Inc. I understand that the failure of KIDZONE, Inc. to verify this information does not waive my responsibility to comply. COVID19 RELEASE PORTION: I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I further acknowledge that Kidzone,Inc. has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19. I further acknowledge that Kidzone, Inc. cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Kidzone, Inc. staff, and other gym clients and their families. I voluntarily seek services provided by Kidzone, Inc. and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending Kidzone, Inc. I attest that: * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 14 days. * I have not traveled to a highly impacted area within the United States of America in the last 14 days. * I do not be
I've read the above and agree.
|
|
|
Other Questions/Comments: |
|
|
Credit Card Verification: |
|
|
Card Number: * |
|
|
|
Name as it appears on card: * |
|
|
Card Expiration Month: * |
Exp Year: *
|
|
|
City:
|
State:
Zip:*
|