The PRIDE physical fitness program is a program that is physically demanding and challenging.  At no time will it be the intent of the program to push any individual beyond his or her limits.  Each participant is required to be aware of our “Time  Out” policy.  At any time during an activity, if a participant feels they are having difficulty or require to stop training, they will signal for a “Time Out” by identifying themselves verbally, raising their hand, sitting down, or other signal to notify an instructor: upon signaling “Time Out” training for that individual stops immediately.



The undersigned, individually for himself or herself and/or for participating individuals under the age of 18, represents and warrants that he or she is in good physical condition and fully able to participate in this course. I am fully aware of the risks and hazards connected with the participation in this event, 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 to 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 course.



The undersigned, individually for himself or herself and/or for participating individuals under the age of 18, RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE PRIDE, its instructors, officers, officials, agents,  other participants, sponsors, advertisers, or owners and lessors of property from any and all liability, claims, demands, action and causes of actions whatsoever arising 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 the event is being conducted.



It is the intent of the undersigned, individually for himself or herself and/or for participating individuals under the age of 18, 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 RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of New York and is intended to be as broad and inclusive as the laws of the State of New York permit.



In the event of any injury or medical condition that requires immediate medical condition, the undersigned, individually for himself or herself and/or for participating individuals under the age of 18 consent to treatment by PRIDE and its facilitators.  If treatment becomes necessary, I agree to pay for any such treatment, including treatment received from any other health care provider and including the cost of transportation to the health care facility.



The undersigned, individually for himself or herself and/or for participating individuals under the age of 18 acknowledge that PRIDE may take photographs, videos, or statements during the training sessions that may be used for educational or promotional purposes and consent to the use of these, and waive all rights of compensation.



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 INTENTING TO BE BOUND BY SAME.

Participants name__________________________________ Date____________________   SHIRT SIZE, ADULT    S    M     L     XL

I (parent or guardian) hereby give permission to allow my child to participate in PRIDE.

Name of parent or guardian __________________________________________________

 

Signature of parent or guardian _______________________________________________

Phone Numbers:

Home________________________________Work__________________________Cell___________________________________

Name of Emergency Contact________________________________________Phone:_______________________________

Medical Condition of Participant (condition, medications, allergies, etc.)

__________________________________________________________________________

PLEASE ALSO FILL OUT AND SEND IN THE ORENDA SPRINGS WAIVER.  GO TO APPLICATION AND WAIVER AND SELECT ORENDA SPRINGS WAIVER.