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PLEASE READ CAREFULLY AND BEFORE STARTING A PROGRAM WITH COACH ALDO!!

Aldos Strength & Conditioning Gym, LLC/Aldo De La Garza do not maintain health insurance for injuries to the participant that may arise out of involvement in this activity.

I Agree

By virtue of participation, myself or my child may risk bodily injury, including paralysis, dismemberment, death, and other loss including damage to property.

I Agree

I knowingly and freely assume all such risk for myself or my child.

I Agree

I agree to follow and/or agree to instruct my child to follow all posted safety rules as well as any others given in the course of this training.

I Agree

Aldos Strength & Conditioning Gym, LLC reserves the right to use any photograph/video taken at any event sponsored by Aldos Strength & Conditioning Gym, LLC, without the express written permission of those included in the photograph/video.

I Agree

I hereby authorize and give my consent for medical care to be given in an emergency situation to myself or my child while participating in the training program.

I Agree

I release and hold harmless and promise not to sue Aldos Strength & Conditioning Gym, LLC/ Aldo De La Garza, its owners, managers, trainers, agents, volunteers and assigns with respect to any and all such injury, paralysis, dismemberment, death or loss unless claim is caused by the direct and sole negligence or willful misconduct of Aldos Strength & Conditioning Gym, LLC.

I Agree

I acknowledge that Aldos Strength & Conditioning Gym, LLC has recommended, in writing, that anyone involved in this training receive a full medical physical evaluation from a medical doctor before participation in the training and activities associated with Aldos Strength & Conditioning Gym, LLC.

I Agree

This agreement is binding on my heirs, personal representatives, next of kin, spouse and assigns.

I Agree

 

 

 

 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Third Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Fourth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Fifth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Sixth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Seventh Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Eighth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Ninth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
Tenth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
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:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and special event information.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Consent to Treat
In the event my child is injured during participation in a training activity, and I am unable to be contacted, I give full permission for Coach Aldo on behalf of Aldo's Strength and Conditioning Gym, LLC to seek medical treatment for my child. I acknowledge that there is a risk of injury while participating in the training activities.*
No
Yes

Today's Date
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

For Students - Current School?

For Students - Current Grade?

Primary Sport?

Secondary Sport?

How many years in organized sports?

What is your primary goal for training?
Is the participant allergic to any medications?*
No
Yes
Does the participant have any other allergies?*
No
Yes
Does the participant have any history of asthma?*
No
Yes
Does the participant have diabetes?*
No
Yes

If you answered YES to any of the above questions please provide details here.

Please provide any additional information, goals, concerns you would like Coach Aldo to be aware of.
How did you hear about Coach Aldo?*

If you selected Current client please let us know who referred you.

Please note any medical conditions, injuries or concerns Coach Aldo needs to be aware of.
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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