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Flying Fives, LLC


Informed Consent, Assumption of Risk and Waiver and Release of Liability
(Must be completed and on file prior to participation in any athletic activities) 

In consideration of the opportunity to use the indoor athletic facilities provided by Flying Fives, LLC (“Flying Fives”) located at 3506 Rohr Rd, Groveport, Ohio 43125 (the “Facilities”) I agree as follows:

  1. I (“Releasor”) understand and acknowledge that participating in athletic activities may be dangerous and may involve risks which include, but are not limited to, bodily injury, partial or total disability, paralysis and death. I also recognize that there may be increased risk of such injury to myself because, among other things, no one will be present to monitor my use of the athletic facilities, to determine whether I am doing so correctly or incorrectly, to determine whether I am in distress or to provide any assistance, and I agree to assume such risk. I also understand and acknowledge that the social and economic losses or damages which can result from those risks and dangers can be significant and that not all such risks and dangers may be known or reasonably foreseeable at this time. I accept the responsibility for losses or damages resulting from all such risks and dangers involved in my participation in athletic activities at the Facilities.

  2. I acknowledge that it is recommended that I seek approval from my physician before participating in athletic activities, as there may be significant health risks associated with these activities. I also understand that injury or death may result from my participation in athletic activities at the Facility.

  3. I declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation in athletic activities. I acknowledge that I have either had a physical examination and have been given a physician’s permission to participate in these activities, or I have decided to participate in these activities without the approval of my physician.

  4. I understand that in the event of accident or injury, personal judgment may be required byFlying Fives personnel, employees, agents, representatives, or volunteers regarding what actions should be taken on my behalf. Nevertheless, I acknowledge that Flying Fives and/or Flying Fives personnel may not legally owe me a duty to take any action on my behalf. If medical care is rendered to me, I consent to that care if I am unable to give my consent for any reason at the time the care is rendered.

  5. I understand that the activities, facilities, programs, and services offered at the Facilities may sometimes be conducted by persons who may not be licensed, certified or registered instructors or professionals. I accept the fact that the skills and competencies of some of these individuals will vary according to their training and experience and that no claim is made to offer assessment or treatment of any physical condition by those who are not duly licensed, certified or registered and employed to provide such professional services.

  6. In consideration for being permitted to participate in athletic activities at the Facilities, and because I assume all risks involved in such participation, I hereby agree that I am responsible for any resulting personal injury, damage to, or loss of my personal property which may occur as a results of my participation in the athletic activities.

  7. In consideration for being permitted to participate in the athletic activities at the Facility I, as Releasor, for myself, and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless Flying Fives LLC, its officers, members, agents, instructors, volunteers and/or employees (the “Releasees”) from any and all claims, demands, damages, rights of action or causes of actions ("Claims"), present or future, for any personal injury or death arising out of my participation in any athletic activity at the Facilities, including any personal injuries or death resulting from the negligence of the Releasees to the fullest extent permitted by law.

  8. I agree not to sue any Releasee for Claims, even if the Claims arise from the carelessness, negligence or gross negligence of any Releasee. I agree to indemnify and hold harmless each Releasee from any loss or liability (including any reasonable legal fees they may incur) defending any Claim made by me or anyone making a Claim on my behalf, even if the Claim is alleged to, or did result from the carelessness, negligence or gross negligence of any Releasee.

  9. I grant my permission and license to the Releasee and any transferee or licensee, to utilize any photographs, video recordings, audio recordings and other references or records which may depict, record or refer to me (“Likeness”) for any purpose, including commercial use by the Releasee and their licensees. This permission and license is for use anywhere in the world and on the Internet and for an unlimited period of time. I understand and agree that I will not be compensated or receive additional consideration for consenting to the use of my Likeness and that I will not be given a chance to receive, inspect or approve the promotional or marketing material, messages and/or content that may use my Likeness.

  10. If any provision of this agreement shall 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.

  11. This Agreement shall be construed broadly to provide a waiver and release to the maximum extent permissible under applicable law.

  12. I affirm that I am at least eighteen (18) years of age and fully competent to sign this document; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same.

  13. If I am less than eighteen (18) years of age, a parent or guardian will also sign this document providing their consent to this Waiver and Release.

I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST FLYING FIVES FOR ANY INJURY SUSTAINED.


Today's Date: June 18, 2025


First Participant's Name
First Name*
Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Information
Work Phone
Cell Phone
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
Work Phone
Cell Phone
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
Work Phone
Cell Phone
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
Work Phone
Cell Phone
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
Work Phone
Cell Phone
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
Work Phone
Cell Phone
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
Work Phone
Cell Phone
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
Work Phone
Cell Phone
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
Work Phone
Cell Phone
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
Work Phone
Cell Phone
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.

IF RELEASOR IS LESS THAN 18 YEARS OF AGE, A PARENT OR LEGAL GUARDIAN MUST GIVE CONSENT TO THIS WAIVER AND RELEASE BY SIGNING BELOW, INDIVIDUALLY AND ON BEHALF OF THE RELEASOR.



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*
Relationship*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Information
Work Phone
Cell Phone
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.


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