IN CONSIDERATION of allowing my minor child /ward to participate in the competitions, programs, activities and events of Coach Adrian James and JAMESTOWN BOXING CLUB, I ASSURE TO YOU THAT:

1. I am the parent/guardian of the participant having full legal responsibility for decisions regarding the participant.

2. I believe that my minor/ward is physically, emotionally and mentally able to participate in the programs, activities and events of the Coach Adrian James and JAMESTOWN BOXING CLUB.

3. I hereby acknowledge that I am aware of the risks and hazards associated with or related to the competitions, programs, activities and events of Coach Adrian James and JAMESTOWN BOXING CLUB. The risks and hazards include, but are not limited to injuries from:
a. Physical contact with the instructor, students or other participants;
b. Striking students, participants, objects or equipment;
c. Being struck by the instructor, students, participants, objects or equipment;
d. Contact, colliding, falling or being struck by other participants, spectators or equipment;
e. Executing strenuous and demanding physical techniques;
f. Vigorous physical exertion, strenuous cardiovascular workouts, rapid movements and quick turns and stops;
g. Exerting and stretching various muscle groups;
h. Dry land training includes weights, running, circuit training and massage;
i. Extreme weather and temperature conditions which may result In heatstroke, sunstroke or hypothermia;
j. Falling or colliding with the ring, walls, stands, equipment or with other participants;
k. Failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment;
l. Spinal cord injuries which may render me permanently paralyzed;
m. Travel to and from competitive events and associated non-competitive events, which are an integral part of Coach Adrian James and JAMESTOWN BOXING CLUB’s competitions, programs, activities, and events.

4. Furthermore, I am aware that:
a. Injuries sustained to my child/ward can be severe;
b. My child/ward may experience anxiety while challenging himself/herself during the competitions, activities, events and programs;
c. My child/ward may come into close contact with other participants;
d. My child/ward’s risk of injury is reduced if he/she follows all rules established for participation; and
e. My child/ward’s risk of injury increases as he/she become fatigued.

I UNDERSTAND AND AGREE, on behalf of myself, my heirs, assigns, personal representatives and next of kin that my signing of this document constitutes that:

5. I am registering my/ward willingly and my child/ward is participating voluntarily in these activities, events and programs.
6. A medical doctor has verified my child/ward’s physical condition within the past twelve months.
7. I agree that there are risks as described above and my child/ward will be exposed to these risks and hazards.
8. I agree to accept and assume all these risks and hazards and am responsible for any injury or other loss which my minor child/ward might receive while participating in these competitions, events, activities and programs.
9. If something happens to my child/ward, I RELEASE Coach Adrian James and JAMESTOWN BOXING CLUB of responsibility and liability for any and all claims, demands, actions, judgements, executions and cost, which might arise out of my child/ward’s participation. I understand Coach Adrian James and JAMESTOWN BOXING CLUB to mean: Coach Adrian James and JAMESTOWN BOXING CLUB and their respective directors, officers, committee members, members, clubs, employees, coaches, volunteers, officials, judges, participants, agents, and representatives.