TriSpecific Athlete Info & Waiver
Please Complete the Athlete Info and Waiver (required only once per calendar year).

All information is kept confidential and is not used in any 3rd party marketing.

First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Cell Phone *
Your answer
Email *
Your answer
Age *
Your answer
Emergency Contact Name - Local *
Your answer
Emergency Contact Cell Phone *
Your answer
Allergies
Your answer
Current Medication(s)
Your answer
Any Medical Conditions
Your answer
ASSUMPTION OF RISK, WAIVE OF LIABILITY and IMDEMNIFICATION
I freely choose to participate as a client in TriSpecific Coaching Ltd training program/sessions. I fully understand the nature of the sport I wish to participate in. I recognize that participation in such sport can involve the risk of serious injury, and potentially even the loss of limb or life. Some of the risks are predictable in nature, but unanticipated consequences are also possible. I also understand that open water swimming is fully my own risk based on the knowledge that TriSpecific Coaching Ltd does not provide certified lifeguards or lifeguard service. Knowing all of this, I wish to participate in TriSpecific Coaching Ltd training programs and accept the risks and assume the responsibility for my participation. ASSUMPTION OF INHERENT RISKS: I understand that the inherent risks of the sports activities I am engaging in as well as common minor risks which could include, but are not limited to, property damage, minor muscle strains, muscle sprains, muscular fatigue, cuts, bruising, being struck by a motor vehicle and post exercise soreness. More serious risks include, but are not limited to, joint injuries, torn muscles, heat-related illnesses, eye injuries, broken bones, and back injuries. There is also the more remote risk of a catastrophic incident, for example, stroke, heart attack, paralysis, or death. I understand the types of injuries that may occur as a result of participating in a training program. I hereby assert that my participation in TriSpecific Coaching Ltd training program/sessions is voluntary and that I knowingly assume all inherent risks of the activity. WAIVER OF LIABILITY FOR ORDINARY NEGLIGENCE: In consideration of permission to voluntarily participate in TriSpecific Coaching Ltd training program/sessions, I (on behalf of my heirs, personal representatives, and assigns) do hereby release, waive, and discharge TriSpecific Coaching Ltd and it’s agents from liability from any and all claims arising from the ordinary negligence of TriSpecific Coaching Ltd. This agreement applies to: (i) personal injury (including death) from incidents or illnesses arising from participation in TriSpecific Coaching Ltd training activities, fitness tests, competitions, races; and (ii) any and all claims resulting from the damage to, loss of, or theft of property. INDEMNIFICATION: I agree to hold harmless, defend, and indemnify TriSpecific Coaching Ltd and all of it’s agents (that is, defend and pay any judgment and costs, including investigation costs and attorney’s fees) from any and all claims of mine, my spouse, heirs, personal representatives, or assigns arising from my injury or loss due to my participation in TriSpecific Coaching Ltd, training programs/sessions. I further agree to hold harmless, defend, and indemnify TriSpecific Coaching Ltd, and all of it’s agents (that is, defend and pay any judgment and costs, including investigation costs and attorney’s fees) against any and all claims of co-participants, rescuers, and others arising from my conduct in the course of my participation in TriSpecific Coaching Ltd programs/sessions. COVENANT NOT TO SUE: I covenant not to sue TriSpecific Coaching Ltd and it’s agents for any present or future claim I might have. This includes claims resulting from: (i) the inherent risks of physical conditioning, training, and participating training activities; and (ii) the ordinary negligence of TriSpecific Coaching Ltd. ASSERTIONS, AUTHORIZATIONS, AND AFFIRMATIONS: I assert that I: 1. Possess sufficient physical fitness and skill to enable safe participation in the program. 2. Do not have any medical problems that would contra-indicate participation in the program. 3. Am covered by a 24-hour health and accident insurance policy 4. Emergency Care: I authorize or agree to allow TriSpecific Coaching Ltd and it’s agents to administer emergency first aid and CPR 5. To secure emergency medical care or transportation when deemed necessary by TriSpecific Coaching Ltd. 6. To assume all costs of emergency medical care and transportation. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. By checking the box I confirming that this is my electronic signature and that I am signing this waiver for myself.
I have read, I understand and agree to the TriSpecific Athlete Waiver *
Required
Electronic Signature - Your Name *
Your answer
10 + 4 *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of TriSpecific. Report Abuse - Terms of Service