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Parent Consent, Release of Liability, & Indemnification Agreement & Media Consent and Release for Cheer Destiny

​PLEASE READ CAREFULLY – YOU ARE GIVING UP LEGAL RIGHTS BY SIGNING THIS!

In consideration of being allowed to use the facilities and participate in the classes, camps, clinics, programs, cheerleading activities, tumbling instruction, open gym, and other related activities (the “Cheer Activities”) at Cheer Destiny, I hereby waive, release and discharge, individually and on behalf of my heirs, executors, administrators, personal representatives, assigns, and the above-named minor, to the fullest extent permitted by law, any and all rights, claims, or causes of action against Cheer Destiny LLC, its staff, members, managers, agents, representatives, volunteers, affiliates, sponsors, successors and assigns (collectively, the “Company”), for any and all injuries, losses, or other damages to myself or the above-named minor, arising out of or in any way related to the Cheer Activities, including injuries, losses, or damages caused by the negligent acts of the Company. I acknowledge that cheerleading, stunting, and tumbling are active, physical sports consisting of running, flipping, tumbling, twisting, and other athletic movements, and that participation in Cheer Activities involves potentially hazardous activity with known, unanticipated, and inherent risks of danger or injury, including, but not limited to, physical or emotional injury, including sprains, strains, tears, fractures, dislocations, contusions, lacerations, concussions, paralysis, or even death (collectively referred to as “Risks”). I understand that such Risks cannot be completely eliminated without compromising the essential value, enjoyment, and benefits from the unique experiences and value that the Company provides. I understand that the number of participants will be greater than the number of staff and that participants will not receive individualized attention. I hereby acknowledge that my child is physically and mentally capable and able to participate in the above referenced activities and has no health or other problems that would put the child at risk by participating in such activities. I understand that participation in the Cheer Activities is voluntary and acknowledge that staff assistance and/or medical facilities may not be available in the event of illness or injury. I also acknowledge that the Company does not provide medical insurance covering any injuries incurred during Cheer Activities or while using Company’s facilities.

ASSUMPTION OF RISK. ​I understand and acknowledge that it is my sole decision whether to consult with a medical professional prior to my or the above-named minor’s participation in the Cheer Activities and that the Company recommends that participants consult with a medical professional prior to participating in the Cheer Activities. I hereby accept any and all Risks, on behalf of myself and the above-named minor, including any personal injury, disability or death, as well as any damage to, loss or theft of any personal property that I may incur resulting from participation in the Cheer Activities.

RELEASE OF LIABILITY AND INDEMNIFICATION​. I understand that myself and/or the above-named minor will be engaging in the Cheer Activities and using the Company facilities and it is my voluntary and informed decision to participate, regardless of the associated Risks and inherent dangers. I expressly release and forever discharge and hold Company harmless from any and all liability, claims, lawsuits, demands, or causes of action whatsoever arising out of any damage, loss, personal injury, or death, while participating in the Cheer Activities or using Company facilities. If there is any claim based on injury, loss or damage described herein, which involves me or the child, I agree to defend and indemnify Company against such claims and reimburse Company for any and all expenses relating to said claim.

ADDITIONAL REPRESENTATIONS RELATING TO MINORS. ​I understand that every precaution will be taken to protect the safety of each participant in this program. However, I also understand that I am responsible for all personal medical insurance for the participating child and that I will be responsible for any medical costs incurred as a result of the child’s participation in this program or use of the Company facilities. I agree to assume full risk for any and all activities in which the child may participate and I hereby waive, relinquish and release any and all claims which I and/or the child may have or obtain in the future against the Company as a result of injury which I and/or the child may sustain in any activity associated with participation or use of Company facilities. I affirm that I have adequate and appropriate insurance to provide coverage for such medical expenses. In case of medical emergency, I authorize Company to arrange for emergency medical treatment of the child at my sole cost.

I HAVE CAREFULLY READ THIS PARENT CONSENT, RELEASE OF LIABILITY, & INDEMNIFICATION AGREEMENT IN ITS ENTIRETY AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A WAIVER AND RELEASE OF LIABILITY AND A LEGAL CONTRACT BETWEEN ME AND CHEER DESTINY LLC AND THAT IT AFFECTS MY LEGAL RIGHTS. I AM SIGNING THIS DOCUMENT OF MY OWN FREE WILL. I ATTEST THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE CHILD NAMED ABOVE.

PLEASE NOTE THAT BECAUSE WE DO POST AND CREATE FORMS OF MARKETING THAT MAY INCLUDE YOUR CHILD'S APPEARANCE IN OUR ADVERTISEMENTS AND SOCIAL MEDIA WE REQUIRE THAT ALL PARENTS ALSO AGREE TO THE CLAUSE BELOW:

MEDIA CONSENT AND RELEASE FOR MINOR CHILDREN

I certify that I am the parent/guardian of (Name Below) (“My Child”). I
represent that I am at least 18 years of age and am fully competent to sign this Release on behalf
of myself and My Child. I therefore agree as follows:
1. I agree that My Child may be photographed, recorded, and videotaped by Cheer
Destiny, LLC (“Company”) and its agents.
2. I authorize Company and its agents to copyright, publish, reproduce, exhibit, transmit,
broadcast, televise, digitize, display, distribute, license to third party, and otherwise use and
permit others to use: (a) My Child’s name, image, likeness, and voice; and (b) all photographs,
recordings, videotapes, audiovisual materials, writings, statements, and quotations of or by My
Child and furnished to the Company by My Child or myself (collectively, the “Materials”), in
any manner, including on the Internet, and for any purpose, including, but not limited to,
advertising or promotion of Company, its affiliates, or their services.
3. I understand that all of the Materials are the sole property of Company. I agree not to
contest the rights or authority granted to Company under this Consent and Release Agreement. I
release, discharge, and agree to indemnify and hold harmless Company, its employees, licensees,
agents, successors, and assigns from any claims arising by reason of defamation, invasion of
privacy, right of publicity, copyright infringement, or any other personal or property rights from
or related to any use of the Materials. I understand that Company is under no obligation to use
the Materials.
4. This document contains the entire agreement between the Company and the
undersigned with respect to the subject matter of this Consent and Release Agreement. This
agreement shall be governed by and construed in accordance with the laws of the State of Illinois
without regard to conflicts of law rules. I agree to execute any further documents or instruments
requested by Company in order to evidence or confirm these rights.
5. I agree that My Child is participating on a voluntary basis and My Child and I will not
receive any payment from Company for signing this release or as a result of any publication of
the Materials.
THIS IS A RELEASE OF LEGAL RIGHTS.
READ IT CAREFULLY AND BE CERTAIN YOU UNDERSTAND IT BEFORE SIGNING

COVID-19 Addendum - Effective as of 6/1/2020

As an Addendum to the Parent Consent, Release of Liability, & Indeminfication Agreement you may have or have not previously signed with us as a member, you agree and understand the following:

By entering this facility, you are aware that you agree to fully accept all known and unknown risks, including the potential risk of exposure to respiratory illnesses such as the coronavirus (COVID-19). The coronavirus is primarily transmitted via exhaled respiratory droplets, most often through coughing and sneezing. These droplets can travel up to six feet and are more commonly transmitted between persons rather than from equipment to persons. 

Although we regularly sanitize our equipment and presently are using enhanced cleaning methods and enforcing social distancing in our facility, you understand that you may be exposed to the coronavirus or its symptoms through no fault of our own. Known coronavirus symptoms include fever, coughing, shortness of breath, pneumonia,  kidney failure, and may include other symptoms, stroke or even death (collectively "Symptoms"). You understand and agree that you will hold us harmless and you will not hold us liable for any real or perceived Symptoms of COVID-19 or any other disease, illness, or condition, nor for exacerbating any existing symptoms, and you fully agree to accept all risks of entering the facility, using the equipment, working with personal trainers, attending classes, and/or interacting or being exposed to other members.

 

Today's Date: April 19, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
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*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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.


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*

Phone*
Parent or Guardian's Age Acknowledgment*
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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