Children's Consent and Waiver Form

Child's Name

Name of Parent/Guardian

Date of Birth

Contact Number

Secondary Emergency Contact:

Please confirm:

Does your Child have any allergies?

Does your Child have asthma?

As your Child's trainer(s), is there anything I/we need to know that would compromise their ability to participate in class?

If YES, please provide details:

PLEASE READ CAREFULLY

Motiv8 Fitness Consent Form for Parents of Children under the age of authority participating in the activities run through Motiv8 Fitness.

It is the parent’s responsibility to inform us of any and all injuries, physical limitations or special needs of participating children prior to session registration.

All of our trainers are certified in Child First Aid and should an accident occur, the utmost care will be taken, including arranging emergency medical care if required. We will contact the person listed as the emergency contact in such circumstances.

By allowing your child to participate in this activity, you are accepting the risk of an accident occurring, and agree that this activity, as described above, is suitable for your child.

IDEMNIFICATION

I recognise that there is risk involved in the types of activities offered by Motiv8 Fitness and Nutrition. Therefore, I accept financial responsibility for any injury that I or my child may cause either to himself/herself or to any other participant due to his/her negligence. Should the above-mentioned parties, or anyone acting on their behalf, be required to incur legal fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Motiv8 Fitness and Nutrition, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my or my child’s negligent or intentional act or omission while participating in activities offered by Motiv8 Fitness and Nutrition. I have fully read and fully understand the foregoing assumption of risk and release of liability, and I understand that signing it obligates me to indemnify the parties named for any liability for injury or death of any person and/or damage to property caused by my or my child’s negligent or intentional act or omission. I understand that by signing this form, I am waiving valuable legal rights.

PHOTO / VIDEO Release

I hereby grant Motiv8 Fitness and Nutrition permission to use my child’s photograph/video image in any and all publications for Motiv8 Fitness and Nutrition, including social media. Please uncheck this box to opt out.

Parent/Guardian's Intials

Date

Thanks for submitting!