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Em's FitKids and FitTeens Summer Camp Registration
Register your kid for Summer Camp!
* 7/10 (M - TH) - Entering 1st and 2nd Grade
* 7/17 (M - TH) - Entering 2nd, 3rd and 4th Grades
* 7/24 - (M - TH) - Entering 6th, 7th and 8th Grades
* 7/31 - (M - TH) - Entering Highschool Grades
* 8/7, 8/9, 8/11 (M,W,F) - Age 4 - Kindergarten
* 8/8, 8/10 (T,TH) - Ages 2 and 3 (Toddler and Me!)
Child's Name
*
First
Last
Date of Birth:
*
MM
/
DD
/
YYYY
Age group
*
Please select
Entering 1st, 2nd Grade
Entering 3rd, 4th, 5th Grade
Entering 6th, 7th, 8th Grade
Entering High School
4 Years Old - Entering Kindergarten
2, 3 Years Old (Todder & Me!)
Enter Newport Fitness Member Discount Code
Member Discount
$
Dollars
.
Cents
Select T-Shirt Size
*
Please select
2T
3/4T
5/6T
Youth Small (6/8)
Youth Medium (10/12)
Youth Large (14/16)
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
List any Food Allergies and Limitations
Guardian Information
Please enter parent or legal guardian information here
Name
*
First
Last
Phone
*
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###
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####
Email
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
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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Clear
Total
$0.00