2388 New Haven Rd. ¨ Bardstown, KY.  40004 ¨ 502-348-2164

 

 

ASSUMPTION OF RISK, WAIVER OR LIABILITY,

MEDICAL AUTHORIZATION

 

 

As Legal Guardian of _____________________________________ (child) or as an Adult Participant ______________________________________(myself), I recognize that potentially severe injuries, including but not limited to catastrophic injury, permanent paralysis, or death can occur in sports activities involving height or motion, including but not limited to gymnastics, tumbling, trampoline, cheerleading, sports conditioning, and general fitness.  Being fully aware of these dangers, I voluntarily consent to the aforementioned person participating in any Fit Kids, Inc. programs and activities and I accept ALL RISKS associated with that participation.

 

In consideration for allowing my child to use the facility, I on my own behalf and the behalf of my child and our respective heirs, administrators, executors and successors, hereby covenant NOT TO SUE and FOREVER RELEASE Fit Kids, Inc., it’s officers, directors, or employees.

 

IN THE EVENT OF AN EMERGENCY, I would like my above mentioned child or myself to be taken to a hospital for medical treatment and I HOLD Fit Kids, Inc. and it’s representatives harmless in their execution of this action.  Additionally, I hereby agree to individually provide for all possible future medical expenses which may be incurred by myself or my child as a result of any injury sustained while participating at Fit Kids, Inc.

 

 

I HAVE READ AND UNDERSTAND THIS ASSUMPTION OR RISK AND WAIVER OF LIABILITY AND MEDICAL AUTHORIZATION AND I VOLUNTARILY AFFIX MY NAME IN AGREEMENT.

 

 

 

 

 

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PARENT OR LEGAL GUARDIAN’S SIGNATURE                                DATE