PRO 3:5 Sports Academy Waiver
Medical Release *
For and in consideration of the below named participant (the “Participant”), participating in any activity (referenced as the “Program”) or using Pro 3:5 Sports Academy, LLC. facilities, I attest and agree to the following: The Participant, is mentally and physically capable of participating in the program or any Pro 3:5 Sports Academy activities. I understand any evaluation or assessment of physical fitness and any recommendation of activities made by anyone from the Program or Pro 3:5 Sports Academy shall not be a substitute for obtaining such evaluation, assessment or recommendation from my physician before participating in any of the Program activities. Participation is voluntary. I understand that participation in the Program is an inherently dangerous activity and that the risk of participation include, but are not limited to, falls, collisions, cuts, fractures or other injuries. I hereby, for myself, the Participant, my heirs, administrators, executors, personal representatives and assigns, forever waive, release and discharge any and all rights and claims for damages and losses, whether monetary or otherwise compensatory, that I may have against: (i) Pro 3:5 Sports Academy, LLC. and its directors; (ii) executive directors, owners, managers, officers, employees, members, representatives, and agents; and (iii) all coaches, participants, organizers, supervisors, planners, and volunteers for any and all injuries sustained by me arising out of association with, or participation in the Program, any Pro 3:5 Sports Academy activities. I understand and agree that medical or other services rendered to the Participant by or at the insistence of any of the above parties are not an admission of liability to provide or continue to provide any such services and is not a waiver by any said parties of any hereunder. I also acknowledge that, should I, the Participant, require transport to a medical facility, I must pay for such transportation and any treatment rendered. I further agree now and forever to hold the above named and unnamed parties harmless and indemnify them for all claims, damages, judgments and costs of whatever nature and form. The Program recommends that you be examined by your physician before participation. If you have a history of heart disease, you will need to consult a physician prior to participating in Pro 3:5 Sports Academy activities. In the event of an emergency where next of kin cannot be contacted, I authorize Pro 3:5 Sports Academy staff to secure appropriate medical care.
Required
Behavior Acknowledgement *
I understand Pro 3:5 Sports Academy, LLC. or its designate may dismiss any participant (without refund) who has a serious behavior problem, poses a hazard to the safety and rights of others, or who appears to have rejected the reasonable controls of the program.
Required
Media Release *
I give Pro 3:5 Sports Academy, LLC permission to publish in print, electronic or video format the likeness or image of myself and/or my child for the general promotion of Pro 3:5 Sports Academy and its programs.
Required
Parent / Guardian Name *
Your answer
Participant Name *
Your answer
Emergency Contact Number *
Your answer
Parent Email *
Your answer
Event Attending *
Example: Doyle birthday party
Your answer
Thank you.
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