RELEASE OF LIABILITY - DOC by sr07R7bP

VIEWS: 0 PAGES: 1

									                                       RELEASE OF LIABILITY
                                      PLEASE READ CAREFULLY!

       I GIVE MY CONSENT for the minor child listed on this agreement and registration form to
    participate in The Spark Fitness childcare program. I agree to abide by all the terms and policies
                   of The Spark Fitness childcare program as outlined in this agreement.

     I UNDERSTAND AND AGREE TO RELEASE SPARK FITNESS, LLC FROM ANY AND ALL
       LEGAL LIABILITY AND AGREE NOT TO SUE OR MAKE A CLAIM AGAINST, AND TO
    INDEMNIFY AND HOLD HARMLESS SPARK FITNESS, LLC, THE OWNER, AND STAFF OF
   THE SPARK FITNESS CHILDCARE PROGRAM FOR ANY AND ALL CLAIMS FOR DAMAGE,
   INJURIES, OR DEATH TO SAID MINOR CHILD OR ANY PERSON OR PROPERTY CAUSED
     BY OR RESULTING FROM SAID MINOR CHILD PARTICIPATION IN THE SPARK FITNESS
                               CHILDCARE PROGRAM.

    I GIVE CONSENT to The Spark Fitness childcare program staff to provide any and all emergency
   first aid treatment and or refer treatment to a duly licensed physician (MD), Dentist (DDS), or other
         medical provider to the participant. This care may be given under whatever conditions are
         necessary to preserve the life, limb, or well being of the participant. I authorize said minor’s
     transportation to a medical facility, at my expense, as deemed necessary by Spark Fitness, LLC.
      I hereby grant exclusive permission to Spark Fitness, LLC and it agents, to use my child’s name
    and photograph for the purpose of publicity, public relations, editorial, or other marketing program
                               without restriction as to frequency or duration.

   If I am signing this liability release on behalf of a minor, (less than 18 years of age) I represent that
    I am the parent and or legal guardian of said minor child; I accept responsibility for all the medical
     expenses incurred in connection with the program: I agree to indemnify the released parties for
     any and all claims whatsoever brought by the child; and I agree to indemnify the released parties
             for any and all claims brought by a third party arising in connection with the child.

      I HAVE READ AND AGREE TO ALL THE ABOVE POLICIES AS OUTLINED IN THIS
   REGISTRATION FORM AND RELEASE OF LIABILITY. I UNDERSTAND THAT FAILURE TO
   FOLLOW ANY CHILDCARE CENTER OR STATE OF COLORADO POLICIES MAY LEAD TO
    DENIAL OF THE CHILD’S PARTICIPATION IN THE PROGRAM. I VERIFY THAT I AM THE
   PARENT OR LEGAL GUARDIAN OF THE SAID MINOR CHILD AND I AM OF AUTHORITY TO
    ENTER INTO THIS AGREEMENT ON BEHALF OF THE SAID MINOR AND MYSELF, AND I
                         AGREE TO BE BOUND BY ITS TERMS.

CHILDS NAME                                                         DATE



PRINT PARENT/GUARDIAN NAME



SIGANTURE OF PARENT/GUARDIAN


                                                                                                          1

								
To top