WAIVER FORM - Fit Cedar Valley

PARTICIPANTS & SPECTATORS
Please select who will be participating and/or spectating:*
Spectators (those going beyond the lobby area) will need to be included as well.
- Adult(s)
- Minor(s)
- Both
Minor's Name
First Last
Birth Date
MM slash DD slash YYYY
PARENT/GUARDIAN ADDITIONAL AGREEMENT(Must be completed for participants under the age of 18)*
- In Consideration of the minors entered being permitted to participate in FIT activities (including FIT PARK), by checking here, I agree that my child is physically fit enough to participate and has not been advised to refrain from activity. I acknowledge that this waiver can be used by event holders, sponsors, and organizers of events. I further agree to indemnify and hold harmless Releases from any claims alleging negligence which are brought by or on behalf of the minor or connected with such participation by the minor. I understand that as their parent/guardian the participants actions are my responsibility and I will be liable to costs associated with their participation.
Please add participating and spectating adults and minors below.
Please add all participating and spectating minors below.
Please add all participating and spectating adults below.

Name	Date of Birth	Actions

There are no Participants/Spectators.

PARENT/GUARDIAN
First Name*
Last Name*
Phone*
EMERGENCY CONTACT
- Same as Parent/Guardian
First Name*
Last Name*
Phone*
SIGNATURE
Electronic Signature Consent*
- Check Here
You are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
Signature*
Date*
MM slash DD slash YYYY
Email*

27419

PARTICIPANTS & SPECTATORS