Loading...

I hereby acknowledge that participation in this The Athlete Factory training/camp/workouts and its related activities carries an inherent risk of serious physical and/mental injury. I hereby assume the sole responsibility of all such risk of injury and, by my signature below release The Athlete Factory and any affiliated companies, employees and agents thereof from any and all liability arising from injuries sustained by the above named child’s participation in the Athlete Factory training camp/workouts, to include the failure of any equipment or defects in the premises. I hereby authorize any medical treatment necessary for the child listed above incurred while participating in the Athlete Factory training/camp/workouts as determined by a competent medical authority, hospital or professional medical practitioner. 

 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
PAYMENT POLICY
Payment Policy-The Athlete Factory accepts AMEX, Visa, Discover, MC, Cash and Personal Checks. All payments are due on or before the first session on of program. Program's first session will be rescheduled until payment is made. The Athlete Factory will charge a $60 fee for any check returned unpaid by check holder's bank. The check may be returned due to several reasons including but not limited to insufficient funds or closed account. The return fee will be waived only if the reason for the returned check is the account was closed and The Athlete Factory did not cashed the check within 60 days of the postmark on the check. *
I AGREE
REFUND POLICY
If participant has NOT attended the first session within 7 days of purchase, you may receive a full refund. If participant has NOT attended the first session more than 7 days after pack is purchased, you may receive a refund for 40% of Pack purchased. No refund will be given for any Pack, after first session is attended. *
I AGREE
MEDIA CONSENT
Media Consent-I grant permission to The Athlete Factory to make videotapes, photographs, and/or sound recordings, separately or in combination, of my child for marketing purposes ONLY. I also understand that these videotapes, photographs, and/or sound recordings may be used on The Athlete Factory's web site. I understand that my child may be videotaped and/or photographed participating in The Athlete Factory's event(s). Photos and/or video footage will remain the property of The Athlete Factory *
I AGREE
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*

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