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Starz Align, LLC waiver

Starz Align, LLC Student Release.  This waiver not only prevents Starz Align, LLC from being liable for any injuries that may occur, it also holds Dance Starz and Gymstarz from being liable for any injuries and or deaths that my occur.  IN CONSIDERATION of allowing the student named above to enroll at Starz Align, LLC and use of the premises of Starz Align, LLC, the undersigned, being the legal and acting guardians of the student, acting for themselves and/or on behalf of the student, release and hold harmless Starz Align, LLC, its owners, employees, and agents of and from any and all liability , claims, demands, actions, and causes of action whatsoever, arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by the student and/ or the undersigned, while in or on the premises upon which the program is conducted, or incurred while in or on any premises tinder the control or supervision of Starz align, LLC, its owners, employees, renters of the space and agents, or incurred while in route to or from any said premises, or incurred while on any other premises or place while undertaking activities of whatever kind or nature related to activities sponsored by or participated in by Starz Align, LLC, it owners, employees, and agents.  The undersigned, being duly aware of the risks and hazards inherent in participation in dance, trampoline, gymnastics, tumbling, jumps, basketball, volleyball, running or movement on the basketball court, soccer, baseball, softball, dodgeball, roller skating and other movement activities being conducted by Starz Align, LLC, and acting for themselves and the student, herby elect voluntarily to enter upon said premises under the control of Jenna Evans and Stephanie Meza and any coaches. The undersigned, acting for themselves and the student, hereby voluntarily assume all risks of loss, property damage or personal injury, including death, which may be sustained by the student and/ or the undersigned, while in, or on said premises described above.  The owner may, but shall not be obligated to carry insurance on the student and/or the undersigned, and the existence if insurance shall not change, alter, or increase the liability of the owner to the student and/or the undersigned or affect the terms of this release.  This release shall be binding upon the distributes, heirs, next of kin, personal representatives, executors and administrators of the student and each of the undersigned.  The undersigned gives Starz Align, LLC the right to use any type of photography and video of the above student taken during any gymnastics event in which Starz Align, LLC is participating in, for website, advertisement and or business use.  In signing the release, each of the undersigned hereby acknowledges and represents:  a) That he or she has read the foregoing release, understand, it, and signs voluntarily:  b)That the undersigned signing as "legal guardian" is in fact a true legal guardian of the student; each of the undersigned is over 21 years of age and of sound mind, and has signed this release with  the knowledge and consent of the participant, and each of the undersigned understands that this release related to any and all claims of the student and the undersigned.  c) That participation in Starz Align, LLC may have an element of inherent danger or risk, and take full responsibility for my actions and physical condition.  d) To indemnify and hold harmless Starz Align Elite, LLC, coaches, workers, committee members, and host teams from liability, loss. Cost. Or expenses (including but not limited to all fees, medical, and ambulance costs) that may incur while participating in said programs and or competitions.  


 

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*
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

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*

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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