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Athlete Waiver 2024



Acknowledgement, Authorization and Liability Release Agreement

I, the parent/guardian of (child) am acknowledging participation in activities offered and sanctioned by Power Force Athletics Inc. including, but not limited to all areas of cheerleading, tumbling, gymnastics, trampoline, training and/or competition. I am fully aware that activity involving motion, height or athletic activity creates the possibility of serious injury/including death. I release Power Force Athletics Inc., including its owner, agents, officers, directors, shareholders, instructors, and employees from any liability to the above named athlete. I release Power Force Athletics Inc. from liability from an injury arising to the above named athlete on property occupied by Power Force Athletics Inc., including any event sanctioned or sponsored by Power Force Athletics Inc., and/or travel to and from the previous mentioned activities. This release includes but is not limited to any claims of negligence, dangerous conditions, latent defect, premises liability, code violation, vicarious liability, negligent supervision/ maintenance, and/or dangerous equipment; this is intended to be as broad as permissible under Illinois State law. I am fully aware of the nature of the activities provided and the possibility of injuries arising from such activities. I further hold harmless, indemnify and defend Power Force Athletics Inc., including its owner, agents, officers, directors, shareholders, instructors, and employees from any loss, liability, damage, or cost incurred by them due to the above named athlete on the premises occupied by Power Force Athletics Inc. In addition, I give Power Force Athletics Inc. the permission to film, photograph, or videotape the above mentioned athlete for any reproductions, movies, televised events, or promotional print associated or in any way connected with Power Force Athletics Inc. I have read all forms and agree to all terms as stated in each form. I attest that all information given is to the best of my knowledge, factual. I certify that the above-mentioned athlete is in good health and may participate in activities with Power Force Athletics Inc. In case of an emergency where the parents cannot be reached, I authorize Power Force Athletics to secure medical care for the above- mentioned athlete. I further agree to hold harmless the owner and operator of the real estate where such training will occur from any obvious defects in the premises, including by not limited to parking areas, common areas, and walk ways. I understand all terms of this membership contract.



First Athletes's Name

First Name*

Last Name*
First Athletes's Age Acknowledgment*
First Athletes's Date of Birth*
I certify that I am 18 years of age or older
First Athletes's Signature*
Second Athletes's Name

First Name*

Last Name*
Second Athletes's Date of Birth*
Third Athletes's Name

First Name*

Last Name*
Third Athletes's Date of Birth*
Fourth Athletes's Name

First Name*

Last Name*
Fourth Athletes's Date of Birth*
Fifth Athletes's Name

First Name*

Last Name*
Fifth Athletes's Date of Birth*
Sixth Athletes's Name

First Name*

Last Name*
Sixth Athletes's Date of Birth*
Seventh Athletes's Name

First Name*

Last Name*
Seventh Athletes's Date of Birth*
Eighth Athletes's Name

First Name*

Last Name*
Eighth Athletes's Date of Birth*
Ninth Athletes's Name

First Name*

Last Name*
Ninth Athletes's Date of Birth*
Tenth Athletes's Name

First Name*

Last Name*
Tenth Athletes's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Insurance Information

Insurance Carrier:

Policy Number:

Primary Carrier:

Relationship to the athlete:
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*
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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