Youth Waiver Agreement of Release and Waiver for Youth Section 1 of 2 (to be completed by youth member)Name(Required) First Last Phone(Required)Date of Birth (YYYY-MM-DD)(Required) Address(Required) Street Address City Province Postal Code Email(Required) Emergency Contact Name(Required) Relationship to Emergency Contact Emergency Contact Phone(Required) As a member of Heritage Fitness, I agree to the following:(Required) That the use of the fitness facilities, equipment and participation in fitness activities carry a degree of risk in using the facility. That my participation in such activities and/or use of such equipment has the possibility of injury and that it is my responsibility to consult with a physician regarding my ability to participate before coming to Heritage Fitness. I attest that I have no psychological, medical or emotional condition that would prevent me from safe participation at Heritage Fitness, classes, workshops, or events. I release and discharge Heritage Fitness, its directors, and Instructors from any liability, claim demand or action that I may have resulting from injury, death or damages arising from my participation at Heritage Fitness, including loss that may be deemed negligence of the related party. I release and discharge Heritage Fitness, its directors and its instructors from any and all liability, claim, demand or action that I may have related to the loss, theft or damage of any of my personal property from Heritage Fitness premises. I have read this agreement, fully understand its content and meaning and sign it on my own free will. Section 2 of 2 (to be completed by parent or guardian)Parent or Guardian Name(Required) First Last As the legal guardian of this youth, I consent to the above terms and conditions.(Required) Yes No Date(Required) MM slash DD slash YYYY Signature
