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Please read and sign the attached waiver BEFORE your first class.

WAIVER OF LIABILITY

For and in consideration of being permitted to participate in activities sponsored by Releasee at 233 Marlboro Street, Keene, New Hampshire, and other good and valuable consideration the receipt and sufficiency of which is acknowledged, I RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE Kickboxing Keene, LLC, and its directors, officers, employees, volunteers, representatives, and agents (referred to collectively as “Releasee”) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, whether caused by the negligence of Releasee, or otherwise, while participating in such activities, or while in, on, or upon the premises where the activities are being conducted. These activities include, but are not limited, to physical exercise, cardiovascular and strength training.  

    I can fully participate in these activities, and I am fully aware of the risks and hazards connected with the activity. I hereby elect to voluntarily participate in said activity, and to enter the abovenamed premises and engage in such activities knowing they may be hazardous. I voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including death, that may be sustained, or any loss or damage to property, as a result of being engaged in such activities, whether caused by the negligence of Releasee or otherwise.

    This Waiver of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

    IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Waiver for full, adequate, and complete consideration fully intending to be bound by same. 

May 13, 2025

May 13, 2025

Sign Up Requirements:

1.PLEASE DO NOT COME TO CLASS IF YOU ARE SICK OR HAVE A FEVER. If your instructor suspects you are sick, you may be sent home to preserve the health our students. 

2. You must use MINDBODY to sign up for classes. Walk-ins will not be permitted.

3.  If you are a new student, you MUST contact Kerry to schedule your first class in advance. There may be a waitlist for start dates with new students. We will do our very best!! 

4. The sign up window will open on a Saturday for the following week. This is as far as you’ll be able to book your class (7 days). Each Saturday morning it will reset. This allows us to adjust the schedule as needed.  If you try to book beyond the current week, it will say “please call.”  

5. The doors will be open 15 minutes prior to the start time of your class.  

6. After each class you will be responsible for disinfecting your heavy bag top AND its base, plus any other equipment you used (we have wipes etc for this purpose).


Other Helpful Information / Policies:

PRICE OF A SINGLE CLASS

Single Class Non Member                                        $20.00

Single Class Member                                                $15.00

(New Option) 5 Class Punch Card*                    $65.00

*Cannot be combined with first 2 class at $20, meaning, you can’t use this for “5 classes, with gloves."

If you pay cash upon arrival, you must have a minimum of 1 class prepaid on file at all times to accommodate a late cancellation fee.

LATE CANCELLATIONS:

Late cancellation fees ($10 if you cancel class within 3 hours of the start time) will result in an automatic fee of $10. If you have an unlimited program, this will be charged to your credit card on file. 

If you do not have a credit card on file, it will be added to the cost of your program the following month. 

If you have a class punch card, a class will be deducted from your remaining classes.

 If you pay cash upon arrival, you must have a minimum of 1 class prepaid on file at all times to allow you to sign up for class, and to accommodate a late cancellation fee.

 For TRUE emergencies, please contact Kerry via text at 603-398-5982.

PUNCH CARD EXPIRATION DATES:

Please note expiration dates on class cards: A 10 class punch card expires 10 months after the date of purchase. A 5 class punch card expires 5 months after the date of purchase.

ANYTHING THAT SAYS “LESS $20 ALREADY PAID”

This can ONLY be used after your very first 2 classes, when you paid $20 for 2 classes with gloves (basically you are applying the first $20 toward our normal prices, which means you received free gloves). 




I have read and accept all of the provisions in this document.

I Agree
May 13, 2025

 

 












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*
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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