Loading...

Energy Sports Complex
 

 

The health and well-being of our players, coaches, and families remains our top priority.  In order to minimize the risk of COVID-19 entering our environment and spreading amongst our community, we will only allow coaches and players in the facility at their scheduled practice time.  No spectators will be allowed at practice.

Furthermore, all participants in sponsored activities at Energy Sports Complex (“Energy”) must agree to and abide by the following:

  • If the player or parent is sick, please do not come to the practice facility.
  • Players and coaches may arrive no more than 15 minutes before practice starts and must be picked up/leave no more than 15 minutes after practice concludes.
  • There will be no spectators allowed at practices

Energy has put in place numerous preventative measures and enhanced cleaning protocols to reduce the likelihood of spreading COVID-19 in the gym environment; however, Energy cannot guarantee that you or your child(ren) will not become infected with COVID-19.  Further, attending activities at any of Energy’s facilities could increase your child(ren)’s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily agree to the participation terms described above and assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending activities at Energy’s facility and that such exposure or infection may result in personal injury, illness, permanent disability, and death.

I understand that the risk of becoming exposed to or infected by COVID-19 at Energy may result from the actions, omissions, or negligence of myself and others, including, but not limited to, club employees, volunteers, coaches, players, and their families.  I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at Energy or participation in club programming.

On my behalf, and on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless Energy, its employees, officers, directors, agents, and representatives, of and from any such claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.

I understand and agree that this release includes any claims based on the actions, omissions or negligence of Energy, its employees, officers, directors, agents, and representatives, whether a COVID-19 infection occurs before,, during, or after participation in any club activity.

Today's Date: April 25, 2024

First Player Name

First Name*

Last Name*
First Player Age Acknowledgment*
First Player Date of Birth*
I certify that I am 18 years of age or older
First Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
First Player Signature*
Second Player Name

First Name*

Last Name*
Second Player Date of Birth*
Second Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Third Player Name

First Name*

Last Name*
Third Player Date of Birth*
Third Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Fourth Player Name

First Name*

Last Name*
Fourth Player Date of Birth*
Fourth Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Fifth Player Name

First Name*

Last Name*
Fifth Player Date of Birth*
Fifth Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Sixth Player Name

First Name*

Last Name*
Sixth Player Date of Birth*
Sixth Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Seventh Player Name

First Name*

Last Name*
Seventh Player Date of Birth*
Seventh Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Eighth Player Name

First Name*

Last Name*
Eighth Player Date of Birth*
Eighth Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Ninth Player Name

First Name*

Last Name*
Ninth Player Date of Birth*
Ninth Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Tenth Player Name

First Name*

Last Name*
Tenth Player Date of Birth*
Tenth Player Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Player has been vaccinated*
Yes
No for Religious Reasons
No for Medical reasons
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!