Athletika Sports and Fitness LLC Waiver
I have read this Assumption of Risk, Waiver of Liability, and Indemnification Agreement and fully understand its terms. I understand that I am giving up substantial rights, including my right to sue. I further acknowledge that I am signing the agreement freely and voluntarily, and intend my signature to be a complete and unconditional release of all liability due to ORDINARY NEGLIGENCE of Athletika Sports and Fitness LLC (and other Released Parties) or the INHERENT RISKS of the activity, to the greatest extent allowed by law in the State of Michigan.
This Agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.
Email address *
Please describe what type of event you're attending? (Examples- Jim Smith Bday, 14U Ravens Team Party, Webster Elementary Activity Night, Obstacle Course Drop-in) *
Your answer
Parent/Guardian/Adult Participant First Name *
Your answer
Parent/Guardian/Adult Participant Last Name *
Your answer
Parent/Guardian/Adult Participant Phone Number *
Your answer
Parent/Guardian/Adult Participant Address (House Number/Street) *
Your answer
Parent/Guardian/Adult Participant City *
Your answer
Parent/Guardian/Adult Participant Zip (and state, if other than Michigan) *
Your answer
Parent/Guardian/Adult Participant Date of Birth *
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Emergency Contact Name
Your answer
Emergency Contact Phone Number
Your answer
By adding one or more names below, I acknowledge and provide Parental and/or Legal Guardian Consent (required if the participant is less than 18 years of age). As the Parent and/or Legal Guardian to the child/minor identified below, I hereby accept and agree to all of the terms and conditions of this Agreement on behalf of the child/minor in connection with the child/minor’s participation in any Athletika Sports and Fitness LLC events and activities. If, despite this Agreement, I, or anyone on the child/minor’s behalf, make a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities which any may be incurred as the result of such claim.
Child One- First and Last Name
Your answer
Child One- Date of Birth
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Child Two- First and Last Name
Your answer
Child Two- Date of Birth
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DD
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Child Three- First and Last Name
Your answer
Child Three- Date of Birth
MM
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DD
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Child Four- First and Last Name
Your answer
Child Four- Date of Birth
MM
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DD
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YYYY
Child Five- First and Last Name
Your answer
Child Five- Date of Birth
MM
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DD
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YYYY
Child Six- First and Last Name
Your answer
Child Six- Date of Birth
MM
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DD
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YYYY
Thank you for completing our online waiver!
A copy of your completed waiver will be emailed to you immediately after successful completion. Please review the entire list of RULES, ASSUMPTION OF RISK, WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT by using the following link at:
http://athletikasports.com/about-us/waiver/
A copy of your responses will be emailed to the address you provided.
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