EmailMe Form - Em's FitKids and FitTeens Summer Camp Registration

Child's Name *

First Last

Date of Birth: *

MM / DD / YYYY

Age group *

Enter Newport Fitness Member Discount Code

Member Discount

$ Dollars . Cents

Select T-Shirt Size *

List any Food Allergies and Limitations

Guardian Information

Please enter parent or legal guardian information here

Name *

First Last

Phone *

### - ### - ####

Email *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Liability Waiver & Signature

1. Assumption of Liability Generally: I understand that I must sign a Release of Liability, Waiver of Claims, and Assumption of Risk Agreement on behalf of the child of which I am a parent or guardian. I acknowledge that the Facility would not allow me or my child to use its services, including, but not limited to, use of exercise equipment, and the attendance in any class unless I previously sign this Agreement. I understand that I, and my child, am under no obligation to use the Facility, its equipment, or to participate in any class and that such use or participation is voluntary. I hereby agree to freely, voluntarily, and expressly ASSUME and ACCEPT any and all risks of injury or death that may occur or result at the facility from my use or the child's use, of which I am a parent or guardian.

2. Release of Liability: I accept the premises and exercise equipment on behalf of my child of which I am a parent and/or guardian for use AS IS and without any warranties expressed or implied. In consideration for the use of the Facility’s services, equipment, or participation in any class, I hereby agree as follows: To the fullest extent permitted by law, I hereby release, hold harmless, and waive any and all claims that I have or may have in the future against all individuals and entities including the Facility, its affiliates, and their respective officers, independent contractors working at the Facility, employees, directors, shareholders, attorneys, predecessors, successors, and assigns from any and all liability for any loss, damage, injury, or expense that I or the child of which I am a parent or guardian of may suffer or that my next of kin may suffer as a result of my use or presence at the Facility, including use of exercise equipment, participation in any class due to any cause whatsoever including negligence on the part of the Facility, breach of contract, breach of warranty, or any other legal theories, and I accept full liability and responsibility for any and all such injuries or damages to myself or the child of which I am a parent or guardian of.

3. Personal Property and Valuables: I agree that the Facility will not be liable for the loss or theft of, or damage to, my personal property.

4. COVID-19 Assumption of Risk and Liability Waiver: Please understand that despite all the precautions that you, other members, and/or AFFILIATE may take, we cannot guarantee your health or safety, and you may still be exposed to COVID-19, including through interactions with other individuals who have COVID-19. By executing this release and gaining access to the facility, you, on behalf of yourself, your heirs, beneficiaries, representatives, successors and assigns: (1) voluntarily assume all risks associated with any exposure to COVID-19, including, but not limited to suffering any type of medical condition, illness and, potentially, death; and (2) knowingly and voluntarily waive, release, covenant not to sue, forever discharge, indemnify, and hold harmless AFFILIATE, its parents and subsidiaries and their respective officers, directors, employees, contractors, agents, representatives, successors and assigns (“Released Parties”) from any and all liability, damages, losses, suits, demands, causes of action to the fullest extent permitted by the laws of this state, or any other claims of any nature whatsoever, arising out of or relating in any way to your use of the facility and your potential exposure to COVID-19.

5.Photo Release: I will allow Covington Fitness LLC to take photos of myself and the child of which I am a parent or guardian at their facility and permit them to use these pictures for marketing or advertising for future events and promotion.

6. Understanding of Release: I acknowledge that I have carefully read, understood, and agree to the terms of this Agreement. I give this release with the understanding that physical exercise with or without the use of exercise equipment and machines and whether or not in an exercise class has risks of a variety of physical injuries and illness including muscle pulls, sprains, and the risk of heart attack which can result in death. I am aware that this is a legally binding agreement and that I am not relying on any oral or written representations other than what is set forth herein to sign in this Agreement. I have read and understand this Agreement and I am aware that by signing this Agreement I may be waiving certain legal rights including the right to sue the Facility and all individuals and entities associated with the Facility as set forth above, resulting from the my use of equipment, participation in a class or presence at the Facility, its parking lot, and/or the outside exercise premises.

PLEASE SIGN LIABILITY WAIVER BELOW: *

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