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Ultimate Revolution Athletics-Release of Liability 


To the best of my knowledge, I, parent of the undersigned minor(s) acknowledge that my named child is in good physical condition and fully able to participate in physical activities including but not limited to cheer, tumbling, classes and open gyms at Ultimate Revolution Athletics, LLC. I am fully aware of the risks and hazards connected with the participation in this sport, including physical injury or even death, and hereby elect to voluntarily participate in said event, knowing that the associated physical activity may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or loss or damage to property owned by me, as a result of participation in this class/team/program. I have read and understand ALL policies set forth by Ultimate Revolution Athletics, LLC. I hereby release the use of any/all photos and videos of my athlete to be used by Ultimate Revolution Athletics, LLC . I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE, Ultimate revolution Athletics, LLC, the staf /volunteers of Ultimate Revolution Athletics, LLC or HQ Tradewinds, LLC, or any other parents/athletes also participating in activities with Ultimate revolution Athletics, LLC, 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, while participating in physical activity, or while on or upon the premises where an event is being conducted.It is my expressed intent that this release and hold harmless agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVE, DISCHARGE, and CONVENTION TO SUE the above named RELEASES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be constructed in accordance with the laws of the State of Wisconsin. In signing this release, I acknowledge and represent that I HAVE READ THE FORGOING Waiver of Liability and Hold Harmless Agreement, UNDERSTAND IT AND SIGN IT VOLUNTARILY as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreements have been made; and I EXECUTE THIS RELEASE FOR FULL, ADEQUATE AND COMPLETE CONSIDERATION FULLY INTENDING TO BE BOUND BY SAME.

July 2, 2024

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.
Insurance

Insurance Carrier*

Insurance Policy Number*
Additional Information

School Attending: *

Grade: *

Medical/Health Concerns/Alerts *
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
First Person Competing Form- Name

First Name*

Last Name*
First Person Competing Form- Age Acknowledgment*
First Person Competing Form- Date of Birth*
I certify that I am 18 years of age or older
First Person Competing Form- Signature*
Second Person Competing Form- Name

First Name*

Last Name*
Second Person Competing Form- Date of Birth*
Third Person Competing Form- Name

First Name*

Last Name*
Third Person Competing Form- Date of Birth*
Fourth Person Competing Form- Name

First Name*

Last Name*
Fourth Person Competing Form- Date of Birth*
Fifth Person Competing Form- Name

First Name*

Last Name*
Fifth Person Competing Form- Date of Birth*
Sixth Person Competing Form- Name

First Name*

Last Name*
Sixth Person Competing Form- Date of Birth*
Seventh Person Competing Form- Name

First Name*

Last Name*
Seventh Person Competing Form- Date of Birth*
Eighth Person Competing Form- Name

First Name*

Last Name*
Eighth Person Competing Form- Date of Birth*
Ninth Person Competing Form- Name

First Name*

Last Name*
Ninth Person Competing Form- Date of Birth*
Tenth Person Competing Form- Name

First Name*

Last Name*
Tenth Person Competing Form- Date of Birth*
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*
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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