Client Name
*
First Name
Last Name
Clients Birthdate
*
MM
DD
YYYY
Phone
*
(responsible party phone number)
(###)
###
####
Address
*
(responsible party address)
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
What class/classes would you like to sign up for?
*
Emergency Contact Name
*
In case of emergency, please list the name(s) and phone number(s) of whom you would like us to contact other than the parent or guardian:
First Name
Last Name
Emergency Contact Number
*
(###)
###
####
Relationship To Client
*
Mother
Father
Grandparent
Legal Guardian
Other (over 18)
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number
*
(###)
###
####
Relationship To Client
Mother
Father
Grandparent
Other (over 18)
Request for Self-Administration of Medicine
*
If your student does not require medication during class hours select "NO." This form states that your child understands the need for this medication and the necessity to report to the designated FOUNDATION FITNESS OF ALABAMA™ coach of any unusual side effects. He/she is capable of using this medication independently under the supervision of the designated “FOUNDATION FITNESS OF ALABAMA™ coach. By selecting "YES", the parent/guardian acknowledges that they have read and understand the ”FOUNDATION FITNESS OF ALABAMA™ policy regarding the self-administration of medication. Furthermore, the "YES" holds FOUNDATION FITNESS OF ALABAMA™ L.L.C. and all affiliates harmless for any and all outcomes resulting from said self-administration of medication.
Image Release Form
*
I, hereby expressly grant to Foundation Fitness Of Alabama™ (hereinafter called FF), acting as an agent on behalf of FF and its employees, agents and assigns, the right to photograph me and use my image, silhouette and other reproductions of my physical likeness (as the same may appear in any still camera photograph and/or motion picture film) for FF in connection with the exhibition, theatrically, on television or advertising, exploiting and/or publicizing of above-mentioned images and video but not limited to the FF organization or motion pictures. I hereby waive any right that I may have to inspect or approve the finished product or the advertising copy which may be used in connection thereof, or with the use to which it may be applied. I hereby release, discharge and agree to hold harmless FF, its nominees, designees, successors and assigns, or others for whom they are acting, from any liability of any nature or description by virtue of any use whatsoever, whether intentional or otherwise, or from any change that may occur or be produced in the taking of said picture or pictures, or in any processing tending toward the completion of the finished product, unless it can be shown that said use or change is solely for the purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn or indignity.
FF RETAINS ALL RIGHTS: The Participant agrees that FF has all rights to images and sound recordings, for perpetuity unless explicitly noted in this Agreement. The Participant acknowledges and agrees that FF is not liable for any further consideration or accounting, and further claims for any reason. I hereby grant FF and its legal representatives and assigns the irrevocable and unrestricted right to use and publish images of ME or in which the I may be included, for editorial, trade, advertising and any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same. I hereby release Foundation Fitness Of Alabama™ and its legal representatives and assigns from all claims and liability relating to said images.
This Agreement will be construed in accordance with and governed by the laws of the State of Alabama. I am at least eighteen (18) years of age.
Participant Waiver
*
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT
in consideration of participation as a Client in ALL TRAINING BY FOUNDATION FITNESS OF ALABAMA, LLC
I hereby agree as follows:
LIABILITY WAIVER: The applicant agrees for itself and its employees, agents, or volunteers associated or to be associated with the activity for which the application is being sought, to waive and relinquish all claims that may result in any manner against Foundation Fitness Of Alabama™, their directors, officers, employees, agents, volunteers, sponsors, guest participants, public officers and representatives from said applicants.
HOLD HARMLESS: The applicant agrees for itself and/or its employees, agents, or volunteers associated or to be associated with the activity for which the application is being sought to indemnify and hold harmless
Foundation Fitness Of Alabama™, their directors, officers, employees, agents, volunteers, sponsors, guest participants, public officers and representatives, from and against any and all legal actions, claims, damages, losses or expenses arising out of the permitted activity or any activity associated with the conduct of the applicant’s operations, including but not limited to claims for personal or bodily injury, disease or death, theft, or injury to or destruction of property. Further, the applicant agrees to indemnify dation Fitness Of Alabama™, their directors, officers, employees, agents, volunteers, sponsors, guest participants, public officers and representatives for any attorneys fees and court costs incurred or to be incurred in defending any actions brought against them as a result of the applicants use of public and/or private property as set forth in this application.
This Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity.
This Waiver and Agreement will be subject to Alabama law.
I HAVE READ THIS DOCUMENT AND UNDERSTAND THIS AGREEMENT AND ALL GUIDELINES EXPECTED AS A PARTICIPANT IN FOUNDATION FITNESS OF ALABAMA. I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES. I HEREBY RELEASE ALL THE NECESSARY RIGHTS TO FOUNDATION FITNESS OF ALABAMA TO USE ANY AND ALL MATERIALS (i.e. PHOTO, VIDEO PHOTOAGE, LOGOS, MUSIC, LYRICS, PERFORMANCES, INFORMATION, ETC.) THAT HAVE BEEN TAKEN IN PARTICIPATION WITH FOUNDATION FITNESS OF ALABAMA RELATED EVENTS.
Shirt Size
*
Select Size
Shirt Size
*
Select Size
