Waiver - 480 Fitness - Formerly StaFit

Assumption of Risk Form

Children under 18 years of age
Parent / Guardian Contact Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Email*
Emergency Contact Information
Phone*
Email*
Consent with Respect to Minors

As the legal guardian of this child, I agree that neither Elite Fitness, nor the staff, officers, trustees, agents or instructors of either organization may be held liable in any way for any injury, death or other damage to them or their property arising out of or resulting from their participation in activities at or sponsored by Elite Fitness.

Permission is hereby given for any emergency anesthesia, operation, hospitalization or other treatment which might become necessary as a result of my children's participation.
Name of participant under the age of 18
Date of Birth
Month
Day
Year
Name of participant under the age of 18
Date of Birth
Month
Day
Year
Name of participant under the age of 18
Date of Birth
Month
Day
Year
This consent must be completed, signed, and dated by a parent or legal guardian.
Signature*
Please use your mouse, trackpad, or finger to sign your name.
Relationship to above participants*
- Parent
- Legal Guardian
Print Name*
Date*
Month
Day
Year

Contact

info@elitechandler.com

Consult

Visit

2130 W Chandler Blvd
Chandler, AZ 85224

Assumption of Risk Form