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NorthPoint 2017 Fit4Fun Registration Form
PLEASE COMPLETE THIS FORM FOR YOUR GROUP OR ORGANIZATION.
CONTACT INFORMATION
Contact's First Name
Your answer
Contact's Last Name
Your answer
Primary Phone Number
Your answer
Emergency Contact Information
Your answer
Email
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
PARENT/GUARDIAN
ALL PARTICIPANTS OR PARENT/GUARDIAN OF ANY CHILDREN (UNDER 18) WHO WISH TO PARTICIPATE MUST COMPLETE THE FOLLOWING WAIVER RELEASE FORM BEFORE BEGINNING ANY ACTIVITY.
Activity / Event
I/my group will be participating in:
Required
T-Shirt Size
Number of People
Please indicate how many members are in group or if you're registering for yourself only
Required
Participant's Name
Please list the names of those who are in the group.
Your answer
Team Name
Please list the names of those who are in the group.
Your answer
RELEASE/DISCLAIMER
I am requesting to be allowed to participate in the North Point Fit4Fun event (Fit4Fun). Participants take part in Fit4Fun at their own risk. I understand that Fit4Fun activities may involve certain inherent risks, including the risk of physical injury. I currently have no known physical condition that would impair my ability to participate in Fit4Fun, including, but not limited to, engaging in vigorous physical activities. I have carefully considered the risks involved and voluntarily agree to participate in Fit4Fun.

Pictures of you may be taken during Fit4Fun activities. I grant the NorthPoint Health & Wellness Center or its designee permission to use, edit, broadcast, or publish the pictures. I waive any right that I have to inspect or approve the pictures. I understand that I will not receive compensation for use of the pictures, and that the pictures may be duplicated and/or distributed to other public and private organizations.

I have carefully read and fully understand everything written on this form.

If participant is a minor, this form must be signed by a parent or guardian.

I give permission for my child to participate and agree to be bound by the conditions stated in this Waiver Release Form.

I have carefully read and fully understand everything on the form.
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