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Liability Waiver

I, the undersigned, being a participant in the Cheers! Elite Spirit Gym program or being the parent or legal guardian of such a participant in the program, in consideration of my or another’s participation in the program, I hereby, for myself and participant for whom I am a parent of legal guardian release, discharge, hold harmless, and forever acquit Cheers! Elite Spirit Gym and their offices, agents, representatives and employees from any and all actions, causes of action, claims or any liabilities whatsoever, known or unknown now existing or which may arise in the future, on account of or in any way related to or arising out of my participation in the Cheers! Elite Spirit Gym program. Further I assume all liability of any non-participates who accompany me. I understand that I am a volunteer participant for all purposes in the Cheers! Elite Spirit Gym program and as such Cheers! Elite Spirit Gym and their offices, agent’s representatives and employees are not responsible for injury or death of myself and any participating in Cheers! Elite Spirit Gym program.

I hereby grant CESG permission to use my child’s likeness in a photo, video or other digital media in any and all of its publications, including web-based publications.

By signing this form, parent or legal guardian agrees to the above statements. For participants of minority age, this is to certify that I, as a parent or legal guardian do consent and agree to his/her release as provided above of all releases, and for myself, my heirs, assigns and next to kin, I release and agree to indemnify the release from any and all liabilities incident to the child/participant’s involvement in a Cheers! Elite Spirit Gym program as provided above, even in arising from their negligence.

Today's Date: November 20, 2018

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
First Participant's Signature*
Second Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Third Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Fourth Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Fifth Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Sixth Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Seventh Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Eighth Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Ninth Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
Tenth Participant's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
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.
Parent or Guardian's Name

First Name*

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

PARTICIPANT'S NAME: *

BIRTHDAY *

MOTHER'S NAME:

CELL #

FATHER'S NAME:

CELL #
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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