PFX Athletics May Hitters Club
This form must be completed by a person who is 18 years old or older. Where indicated, the camper, if under 18, must indicate her consent to the terms of participation in the camp by entering her name, followed by her Guardian's name. Please read the questions and instructions carefully. Failure to properly complete this Form may result in the Participant being denied participation with the camp.

For purposes of this registration form, the Camper and his or her Parents and/or Guardians acknowledge that "PFXA" refers to PFXA, Inc. d/b/a PFX Athletics; "PFXA Facility(ies) refers to the venue where the camp, clinic, or lesson will be held and may include Legends Way Ballfields, Hancock Park, Sleepy Hollow Sports Complex, or any other venue where the camp, clinic, or lesson may be held or advertised.
Parent and/or Guardian Name *
Your answer
Parent and/or Guardian Cell Phone *
(XXX) XXX-XXXX
Your answer
Athletes First Name *
Your answer
Athletes Last Name *
Your answer
Athletes Home Address *
Your answer
Athletes Age *
Your answer
Parent Email Address *
Your answer
Travel Ball Team *
Your answer
Age Group
For how many years has the athletes played fastpitch softball? *
Player Conduct (by entering the Player's Name, Player consents to the Player Conduct notice) *
I understand and acknowledge that PFX ATHLETICS Staff reserves the right to remove or dismiss any Participant for misconduct without refund. “Misconduct” shall include any action or inaction that, in the sole discretion of PFX ATHLETICS Staff is violent, abusive, unnecessarily rough, aggressive, or otherwise unbecoming of an PFXA Program Participant.
Your answer
Parent/Guardian Consent to the Player Conduct notice *
Please enter Parent or Guardian's Name
Your answer
Insurance Waiver (by entering Player's Name, Player consents to the Insurance Waiver) *
I acknowledge that there may not be medical professionals at the PFXA facility. Notwithstanding the foregoing, I agree to be treated by any medical professional(s) deemed necessary and appropriate in the sole and absolute discretion of PFX ATHLETICS and/or its Staff until such time as I leave the PFX ATHLETICS Facility at the conclusion of the PFXA Program. Such care and/or treatment shall include, but not be limited to, emergency medical care, paramedical care, travel to the emergency room and/or hospital, orthopedic care, respiratory treatment, and surgery. I further agree to assume, to be responsible for, and to pay for all costs and expenses associated with such treatment or care regardless of whether I currently have or expect to have insurance coverage in the future.
Your answer
Parent/Guardian Consent to Insurance Waiver (above) *
Please enter Player's Parent or Guardian's Name
Your answer
Medical Disclosure: *
Player hereby affirms that she has been examined by a licensed physician and is physically able to participate in the PFXA Program. Player has the following allergies and/or medical conditions:
Your answer
Assumption of Risk (by entering Player's Name, Player consents to the Assumption of Risk) *
The physical activities associated with the exercises to be undertaken through the PFXA Program, by their nature, carry with them certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. In addition, accidents and other Participants increase the likelihood of these risks. The PFXA Program involves strenuous exertions of strength, speed, and agility using various systems of the body (muscles, skeletal structures, cardiac functions, respiratory functions, etc.), many of which involve quick movements and sustained physical activity which place stress on the body’s systems. The specific risks range from one activity to another but range from: 1) minor injuries including, but not limited to, scratches, bruises, and sprains; to 2) major injuries including, but not limited to, damage to the eye, broken bones, back injuries, and concussions; to 3) catastrophic injuries including, but not limited partial or full paralysis and death. By entering my name below, I acknowledge having read this paragraph and that I know, understand, and appreciate the risks identified herein and that such risks are not a complete list of possible injuries that may or could occur during participation in the PFXA Program. I understand and acknowledge that PFX ATHLETICS and/or its Staff will not be held liable for any harm or damage that may come to me as a result of the negligent, grossly negligent, or intentional acts of another PFXA Program Participant, guest, invitee, or observer. I further assert that my participation in the PFXA Program is voluntary and I hereby assume all of the risk associated with or arising out of or related to the PFXA Program. I understand and acknowledge that at certain hours there is no supervision by or assistance from PFX ATHLETICS Staff at the PFXA facility(ies). I am also aware that if I am injured, become unconscious, suffer a stroke, heart attack, or become otherwise incapacitated or injured, that there will likely be no one to respond to my emergency and that PFX ATHLETICS has no duty to provide assistance to me.
Your answer
Parent/Guardian Consent to Assumption of Risk *
Please enter Parent or Guardian's Name
Your answer
Use of Name and Likeness (by entering the Player's Name, Player consents to PFX Athletics using her name and likeness as indicated below) *
I hereby grant to PFX ATHLETICS and is successors and/or assigns the absolute right and permission to use my name, likeness, photograph, biography, testimonial, and/or voice, either alone or accompanied by other material, in any manner and any media throughout the World at any time for the purpose of advertising, marketing, and publicizing PFX ATHLETICS’s products or services and for any other lawful purpose subject to the following terms and conditions: (a) any pictures or voice recordings taken of me at the PFXA Program will be the property of PFX ATHLETICS; (b) I waive all rights to inspect and approve the finished product, its use, or such written or spoken copy as may be used in connection therewith; and (c) I will not hold PFX ATHLETICS responsible for any liability resulting from the use of my name, likeness, or photograph(s), including what may be misrepresentation of me, my character, or my person due to distortion or faulty reproduction in the finished product.
Your answer
Parent/Guardian Consent to the Use of Name and Likeness of Player by PFX Athletics *
Please enter Parent or Guardian's Name
Your answer
Special Needs (by entering the Player's Name, Player affirms that she has no Special Needs) *
I understand that the PFXA Program is not equipped to accommodate individuals requiring special care, help, or support due to a mental or physical disease, injury, or disability. I do not require any special accommodation(s) in order to participate in the PFXA Program.
Your answer
Parent/Guardian affirms that Player has no Special Needs. *
Please enter Parent or Guardian's Name
Your answer
Indemnification and Hold Harmless (to be signed by Player AND Guardians, below) *
I HEREBY AGREE TO INDEMNIFY, DEFEND, AND HOLD HARMLESS, AND TO REIMBURSE ON DEMAND PFX ATHLETICS AND PFX ATHLETICS STAFF (“Indemnified Parties”) FOR AND AGAINST ANY AND ALL DAMAGES, LOSSES, LIABILITIES, BODILY INJURY(IES), OBLIGATIONS, PENALITIES, CLAIMS IN LAW OR EQUITY, LITIGATION, DEMANDS, DEFENSES, JUDGMENTS, COSTS, EXPENSES, OR DISBURSEMENTS OF ANY KIND OR NATURE, INCLUDING, WITHOUT LIMITATION, ATTORNEY’S AND EXPERT FEES in any way arising out of or related to the acts or omissions of me (“Indemnitors”) and arising out of or related to (i) any act or omission, negligent or otherwise, of the Indemnitors or anyone directly or indirectly employed by them or anyone whose acts they may be liable relative to the PFXA Program; (ii) any breach by the Indemnitors of any term of this Agreement; and (iii) the cost, including, but not limited to, court costs and reasonable attorney’s fees incurred in enforcing this indemnification provision.
Your answer
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