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Fuze Fit for a Kid! Waiver

This waiver is required for all guests, campers, class attendees, field trips and prospective after-school members as well as their parent/guardians. We respect your privacy and do not sell or forward your contact information. Please come in or call in ahead of time to sign up in advance for all classes. Payment is due before the class is taken, i.e.: we bill one month in advance and deduct via auto-debit/draft. Those wishing to sign up for a camp, special class, or afterschool session will secure a space upon receipt of payment. Individually, one-on-one scheduled sessions will only be officially scheduled when payment is current. Those that cancel sessions (i.e.: personal training) <12 hours before the time of the class will not receive a refund or class credit.

CLASS POLICIES. Students and/or their parents/guardians or siblings may only touch/use equipment specifically used for their class as instructed by their Coach. Adults and non-students are not permitted on the Main Floor. Please bring a water bottle for your child so they are properly hydrated during class. Classes may be observed from the lobby at any/all time(s) no parents are permitted on main floor/exercise room. Private, semi-private and group classes may be scheduled for any youth activity, P.E., field trip or after-school event. No running or yelling on the workout floor. iPods, phones are not allowed on the workout floor. Play fairly, listen attentively, respect each other, and HAVE FUN! Now GO, PLAY and ACHIEVE! Homework Club rules apply for extended time children.

I hereby affirm that he/she and/or are in good physical condition and does not suffer from any disability that prevents or limits his/her participation in this exercise program. In consideration of my child's participation in a FUZE Fit For A Kid! I have enrolled my child in a program of physical activity including, but not limited to aerobics, dance, rock climbing, homework assistance, parties, and circuit training offered by FUZE Fit For A Kid!. I/we understand and am aware that strength, classroom style instruction, flexibility, aerobic exercise, interactive fitness, and traditional exercise equipment and training are a potentially hazardous activity. All of the physical exercise, counseling, and activities at FFFAK involve certain inherent risks. I/we undersand that FUZE Fit for A Kid! classes, camps and the afterschool program may involve the use of the shuttle service and I/we allow my/our my child(ren) to ride on the shuttle. I/we understand that FUZE Fit for a Kid! classes, camps and the afterschool program may involve outdoor activities. I/we hereby release FUZE Fit For A Kid! (employees, managers, owners, shareholders, and contractors), from any claims, demands and causes of action arising from his/her participation in the exercise program, regardless of cause. I hereby release FUZE Fit For A Kid! from any liability now or in the future including, but not limited to, pulls or tears, broken bones, shin splints, heat prostration, knee/ lower back/foot injuries and any other illness, soreness or injury however caused, occurring during or after my childs participation in the exercise program. All releases apply to children receiving Shuttle transportation and services through FUZE contractors on or off-site as well. I further release FFFAK from any liability in the course and provision of emergency treatment or assistance to my minor child(ren). I provide FUZE with express permission to utilize your child' likeness/photograph in our commercials, videos, or related materials.

 

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
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 discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Other information

Health conditions, if any and any information that FUZE staff may find useful

Which class/program is your child participating in (specify 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*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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