RyzAb0ve Fitness Waiver and Release of Liability

RyzAb0ve Fitness

Waiver and Release of Liability

This agreement must be read and fully completed for you/your child to be eligible to participate in any of our classes, camps, or activities.

Participant's First Name*

Participant's Last Name*

Participant's Date of Birth*

Valid Email Address*

example@example.com

Street Address*

Street Address Line 2*

City*

State*

Postal / Zip Code*

Please let us know how you found us or heard about us: **

We currently serve Charlotte and the surrounding areas. Which area are you closest to?*

Verbal Skills*

Full Verbal Skills

Limited Verbal Skills

Nonverbal

Which of our class(es) are you currently interested in?*

Other Class Interest*

Please use this space to disclose any known injuries, limitations, and conditions that we should be aware of prior to participation in fitness, social, or other activities hosted by RyzAb0ve Fitness and it's affiliates. Please specify where needed. Type "N/A" if none apply.*

Please feel free to type below to leave any other information about the participant (including health concerns, support needed, etc) you feel that may be important for us to know. Type "N/A" if no additional information is needed.*

Which of these options is the best way for you to pay for class sessions? Classes are $20 per session or $170 for a 10 class pass. Scholarship opportunities may be available to families in need.*

Please share a photo of the athlete.

We request an image of the athlete within the registration form to help us easily identify them and to celebrate their accomplishments within our community. These photos allow us to recognize and honor each athlete’s unique contributions and milestones.

Drag and drop files here or

Emergency Contact #1

First Name*

Last Name*

Phone Number*

Phone

Relationship to Participant*

Street Address*

Street Address Line 2*

City*

State*

Postal / Zip Code*

Emergency Contact #2

First Name*

Last Name*

Phone Number*

Phone

Relationship to Participant*

Street Address*

Street Address Line 2*

City*

State*

Postal / Zip Code*

Waiver & Release of Liability

By typing my full name below I hereby attest that I have thoroughly reviewed and understand the terms outlined in the waiver and release of liability document and the Code of Conduct linked below, and I willingly agree to abide by them.*

Waiver & Release of Liability

Code of Conduct

Please provide today's date.*

Media Release

I give RyzAb0ve Fitness the right to take photographs, audio or audio-visual recordings of me/my child to be used in promotional, educational, or fundraising materials including, but not limited to videos, pamphlets and brochures. I understand my/my child's name may be used in connection with these materials.

Media Release*

I agree and grant permission

I do NOT agree. I DO NOT grant permission

Send me a copy of my responses

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