Loading...

Waiver and Release of Liability


Waiver and Release of Liability:

I, on my own behalf, and on behalf of my child(ren) or minor(s) listed below and our respective heirs, administrators, executors and successors, hereby acknowledge the risks associated with the activities provided by and performed at Sensory FIT LLC including but not limited to muscle or soft tissue strains, sprains and tears, broken bones and severe injuries including paralysis or death, COVID-19 as well as medical expenses and damages that may result or be associated with such activities, and that I have voluntarily agreed to participate in the same. Therefore, I assume all risks associated with my voluntary participation at Sensory FIT LLC. If I or the minor(s) should incur any such injury, loss or COVID-19, I agree to release and hold harmless Sensory FIT LLC, its board of directors, officers, employees, instructors, agents, representatives, any independent contractors, including any and all instructors, landlords, and its successors as assigned from any claim or liability in any way related to such injuries, even if such injuries are caused by the negligence of such persons/organizations referenced herein. The undersigned further agrees to indemnify and hold harmless Sensory FIT LLC and all parties identified above, from any liability arising out of negligent or intentional conduct of child, parents, family members or parties invited upon the premises by myself, my child(ren) or minor(s) or any family members which results in loss, injury or damage to any other party.


Medical Release:

I hereby authorize and give my consent to Sensory FIT LLC including any of its instructors, volunteers or other authorized employees to provide emergency medical care and to give authority to any emergency unit, hospital or doctor to render immediate aid as might be required for the treatment of the below named participant in the event of any emergency occurring on the premises of Sensory FIT LLC.


Minor’s Release Authorization:

Without compensation to me or the minor(s) listed above, I hereby grant to Sensory FIT LLC, the absolute right and permission to copyright, publish, and use photographic portraits, pictures, or videos of me or the minor for use through reasonable promotion of the facility and related events. I hereby waive any right that I or the minor(s) may have to inspect or approve the finished media material as long as the matter is within reason and is not deemed to be socially inappropriate for use of a minor. As legal parent/guardian/responsible party of the above minor(s), I hereby verify by my signature below, that I have read, understood and accept the terms contained herein; and furthermore, I permit my child(ren) to participate in the selected activities provided by Sensory FIT LLC. 



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*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!