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This is the Waiver for your participation in the BATTLE OF BENTON 15 March 2020.

Please read & sign before entering so you're aware of the potential risks involved on the day of competition. 

Photography/video release:

Participants involved in any activites offered by BENTON CROSSFIT may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation on the BENTON Gym Website or in any editorial, promotional or advertising material produced and or published by BENTON Crossfit.

 

Waiver & Release of liability/ Express assumption of risk:

I, the undersigned am aware that there are significant risks involved in all aspects of physical training. Theres risks include but are not limited to:

Falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner or other people around me; injury or death due to improper use or failure of equipment; strains and sprains. I am aware that any of these above mentioned risks may resuts in serious injury or death to myself and or my partners.I willingly assume full responsibility for the risks that I am exposing myself to at the Battle of BENTON and accept full responsibility for any injury death that may result from participation in any activity under the direction of BENTON Crossfit. I acknowledge that I have no physical impairments, injuries or illnesses that will endanger me or others.

 

Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities at the Battle of BENTON, I undersigned hereby release BENTON Crossfit, their principals, agents, employees and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns or transferees. If any portion of this agreement is held invalid,

 

Indemnification:

The participant recognises that there is risk involved in the types of activites offered by BENTON CrossFit. Therefore the participant accepts financial responsibility for any injury that the participant may cause either to him/herself or to any other participant due to his/her negligence.

Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorneys fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs, I further agree to indemnify and hold harmless BENTON CrossFit, their principals, agents, employees and volunteers from liability for the injury or death of any person (s) and damage to property that may result from my negligent or intentional act or omission while participating in the Battle of BENTON. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building or any area selected for training by BENTON CrossFit.

 

I have read and understood the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.

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*
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.


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