General Liability, COVID, and Photo Release Form
Please read this form carefully and be aware that in signing, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which your child might sustain as a result of participating in any and all activities connected with and associated with Atlas Hoops (Atlas Hoops, LLC).

By signing below I consent that I have read and fully understand, and agree to the above important information, warning of risk, assumption of risk and waiver and release of all claims.
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Email *
Name (First & Last Name) *
Date of Birth *
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DD
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YYYY
Phone Number (xxx) xxx-xxxx *
I further agree to waive and relinquish all claims I may have as a result of my child participating in this program/activity against Atlas Hoops, LLC, including its officials, agents, volunteers and employees (Julian Penaranda). I do hereby fully release and forever discharge the Atlas Hoops, LLC from any and all claims for injuries, damages, or loss that I or my child may have or which may accrue to me or my child, connected with, or in any way associated with this program/activity. *
Required
I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my child may sustain as a result of said participation. *
Required
I hereby forever release and waive my right to bring suit against Atlas Hoops' and its owners (Julian Penaranda), officers, directors, managers, officials, trustees, agents, employees, subcontractors, trainers, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Atlas Hoops' services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen. *
Required
Atlas Hoops cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while utilizing Atlas Hoops' services or premises. It is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize Atlas Hoops’ services and/or enter onto Atlas Hoops' premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19. *
Required
I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children in order to utilize Atlas Hoops' services and enter Atlas Hoops' premises. These services are of such value to me [and/or to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize Atlas Hoops' services and premises in person [if applicable: “rather than arranging for an alternative method of enjoying the same services virtually (e.g. videoconference)]. *
Required
The athlete, parent or legal guardian, hereby authorize Dr. Julian Penaranda, owner of Atlas Hoops to publish the videos and photographs taken of me and/or the undersigned minor children, and our names, for use on Instagram (@atlashoops_702, @dr_julianpenaranda, @peachyking, @hoopfanatictyler, and @velvports) and other social media sites. *
Required
I release Atlas Hoops, Dr. Julian Penaranda, HoopFanatic Media, Peachy King, and Velv Sports from any expectation of confidentiality for the undersigned minor children and myself and attest that I am the parent or legal guardian of the child(ren) listed below and that I have the authority to authorize Atlas Hoops, LLC to use their photographs. *
Required
I acknowledge that since participation in publications and websites produced by Atlas Hoops is voluntary, neither the minor children, nor I, will receive financial compensation. *
Required
I further agree that participation in any publication and website produced by Atlas Hoops confers no rights of ownership whatsoever. *
Required
Instagram Account:
By clicking the checkbox below, I consent that I have read and fully understand, and agree to allow Atlas Hoops to e-mail information regarding upcoming events, individual and group training sessions, and services provided within Atlas' facility. *
Required
By signing below I consent that I have read and fully understand, and agree to the above important information, warning of risk, assumption of risk and waiver and release of all claims. (Please provide First and Last Name) *
Emergency Contact Information (First, Last Name and Phone Number) *
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