New Client Form

Athlete Name *

First Name

Last Name

Athlete DOB *

MM

DD

YYYY

Athlete Phone *

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

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Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT *

In consideration of my use or my child's use of the exercise equipment and facilities provided by Tempo Sports Academy, I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that Tempo Sports Academy and its insurers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me, or my child in, on, or about the premises, or as a result of the use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of Tempo Sports Academy. By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me or my child, and I hereby fully and forever release and discharge Tempo Sports Academy, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said equipment and facilities. I expressly agree to indemnify and hold Tempo Sports Academy harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me or my child. I understand that Tempo Sports Academy does provide supervision, instruction, or assistance for the use of the facilities and equipment, but I agree to be solely responsible for safety and well-being of my child and myself. I agree, on behalf of myself and my child, to comply with all rules imposed by Tempo Sports Academy regarding the use of the facilities and equipment. I agree, on behalf of myself and my child, to conduct myself in a controlled and reasonable manner at all times, and to refrain from using any equipment in a manner inconsistent with its intended design and purpose. I understand and acknowledge that the use of exercise equipment involves risk of serious injury, including permanent disability and death. I understand and agree, on behalf of myself and my child, that Tempo Sports Academy is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises. Waiver and Release For Communicable Diseases Including COVID-19 WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19 ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT In consideration of being allowed to participate on behalf of Tempo Sports Academy workout programs and related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I or my child observe and any unusual or significant hazard during my or my child’s presence or participation, I will remove myself and/or my child from participation and bring such to the attention of the nearest official immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS (insert name of sports organization) their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.