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X-Fat Azz Cycling & Fitness Studio Waiver as of 06.03.20

WAIVER OF LIABILITY FOR X-FAT AZZ CYCLING & FITNESS STUDIO

I/We hereby understand and acknowledge that the training, programs and events held at X-FAT AZZ CYCLING & FITNESS STUDIO may expose me to many inherent risks, including accidents, injury, illness, or even death. I/We assume all risk of injuries associated with participation including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, and all other such risks being known and appreciated by me.

I/We hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in activity. I/We acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in.

After having read this waiver and knowing these facts, and in consideration of acceptance of my participation and X-FAT AZZ CYCLING & FITNESS STUDIO furnishing services to me, I agree, for myself and anyone entitled to act on my behalf, to HOLD HARMLESS, WAIVE AND RELEASE X-FAT AZZ CYCLING & FITNESS STUDIO, its officers, agents, employees, organizers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in X-FAT AZZ CYCLING & FITNESS STUDIO training, programs and/or events.

PHOTOGRAPHY/VIDEOGRAPHY RELEASE

I hereby grant full permission to X-FAT AZZ CYCLING & FITNESS STUDIO to use, reuse, reproduce, publish, or republish any pictures and/or recordings of my participation in training, programs and/or events, for editorial, educational, promotional, advertising, and commercial purposes.

PERSONAL PROPERTY

I understand that I am responsible for my personal property while at X-FAT AZZ CYCLING & FITNESS STUDIO. X-FAT AZZ CYCLING & FITNESS STUDIO takes no responsibility for lost or stolen property. I acknowledge and represent that I have carefully read and understand all terms of this Release and Waiver of Liability.

By my signature I/We indicate that I/We have read and understand this Waiver of Liability. I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
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*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
How did you hear about X-Fat Azz Cycling & Fitness Studio?

How did you hear about X-Fat Azz Cycling & Fitness Studio? *
Cycling Experience
What is your level of cycling?*
Beginner
Intermediate
Advanced
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*

Relationship*

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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