Consent Forms

Student Information:

USA Boxing Hold Harmless Waiver

In consideration for my being allowed to participate in boxing activities at Elite Boxing Fitness Center, I hereby acknowledge that such activities (and the gathering of people in 

 

public generally) include many risks, known and unknown, and that I hereby accept and assume all risks associated with such activity. I further agree to hold USA Boxing, its member, 

 

affiliates, agents, LBCs, directors, employees, volunteers, and other persons associated with USA Boxing harmless from and release them of any liability whatsoever for any and all 

 

claims, demands, damages and causes of action of any nature whatsoever related to my participation in those activities.

Youth Participant Waiver (Release of Liability Agreement)

I hereby understand and acknowledge that participation in the training, programs, and events held by ELITE BOXING YOUTH CHAMPS, INC., hereinafter “Activity” may expose me to inherent risks and dangers including but not limited to accidents, injury and illness. I assume all risk of injuries associated with the participation of instructor and non-instructor lead Activities including but not limited to contact with other participants, falls, effects of weather, including high heat and/or humidity, and all other such risks. I hereby acknowledge my responsibility in communicating any physical and/or psychological concerns that may conflict with participation in Activity. I acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in. In consideration of the risk of injury while participating in any type of Activity, and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this Waiver & Release of Liability Agreement and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge ELITE BOXING YOUTH CHAMPS, INC., their officers, participants, property owners, agents, attorneys, staff, volunteers, heirs, representatives, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity.

I hereby understand and acknowledge that I am voluntarily participating in and/or receiving instruction in the above-mentioned Activity and I am participating in the Activity entirely at my own risk. I agree to indemnify and hold harmless ELITE BOXING YOUTH CHAMPS, INC., their officers, participants, property owners, agents, attorneys, staff, volunteers, heirs, representatives, successors and assigns against any and all claims, suits, or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf, for any injury associated with the participation of instructor and non-instructor lead Activities. If ELITE BOXING YOUTH CHAMPS, INC. incurs any of these types of expenses, I agree to reimburse ELITE BOXING YOUTH CHAMPS, INC. Knowing this, and in consideration of being permitted to participate in and/or receive instruction in Activity, I hereby voluntarily release ELITE BOXING YOUTH CHAMPS, INC., their officers, participants, property owners, agents, attorneys, staff, volunteers, heirs, representatives, successors and assigns from any and all liability resulting from or arising out of my participation and/or receipt of instruction in Activity. I understand and agree that this Waiver & Release of Liability Agreement will have the effect of releasing, discharging, waiving, and forever relinquishing any and all actions or causes of action that I may have or have had, whether past, present, or future, whether known or unknown, and whether anticipated or unanticipated by me, arising out of my participation and/or receipt of instruction in Activity with ELITE BOXING YOUTH CHAMPS, INC., their officers, participants, property owners, agents, attorneys, staff, volunteers, heirs, representatives, successors and assigns. I understand and agree that this Waiver & Release of Liability Agreement applies to personal injury, property damage, any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity, even if caused by the acts or omissions of others or acts of nature.

I understand and agree that by signing this Waiver & Release of Liability Agreement, I am assuming full responsibility for any and all risk of death or personal injury or property damage suffered by me while participating and/or receiving instruction in Activity. I acknowledge that I have carefully read this Waiver & Release of Liability Agreement and fully understand that it is a release of liability. I expressly agree to release and discharge ELITE BOXING YOUTH CHAMPS, INC., any and all of their affiliates, officers, participants, property owners, agents, attorneys, staff, volunteers, heirs, representatives, successors and assigns, from any and all claims or causes of action and I agree to voluntarily give up and waive any right that I otherwise have to bring legal action against ELITE BOXING YOUTH CHAMPS, INC. for personal injury or property damage.

In the event that any damage to equipment or facilities occurs as a result of my, my family’s or persons otherwise under my direction willful actions, neglect, or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness. I understand and agree that this Waiver & Release of Liability Agreement will be binding on me, my spouse, my heirs, my personal representatives, my assignees, my children, and any guardian for said children. I understand and agree that by signing this Waiver & Release of Liability Agreement, I am agreeing to release, indemnify and hold ELITE BOXING YOUTH CHAMPS, INC., their officers, participants, property owners, agents, attorneys, staff, volunteers, heirs, representatives, successors and assigns harmless from any and all liability or costs, including attorneys’ fees, associated with or arising from my participation and/or receipt of instruction in Activity.

I understand and agree that if I am signing this Waiver & Release of Liability Agreement on behalf of a participant under the age of consent (18 years of age), that I will be giving up the same rights for said minor, as I would be giving up if I signed this document of my own behalf. I acknowledge that I have read this Waiver & Release of Liability Agreement and that I understand the words and language in it. I have been advised of the potential dangers incidental to participating and/or receiving instruction in Activity.

In the event that any provision contained within this Waiver & Release of Liability Agreement shall be deemed to be severable or invalid, or if any term, condition, phrase, or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed, and enforced as so limited.

I, the undersigned participant, certify that I have read this agreement, that I fully understand this agreement, and agree to its provisions. I am not under the influence of any drugs, alcohol, or other intoxicants whether prescribed or otherwise. I am not suffering from any illness or incapacity. I am aware that this is a release of liability and a contract and am signing it at my own free will.

Youth Participant Agreement Terms

*Applies to Participants Signing up for a Membership 
Not applicable to Drop-In Class Options

 Electronic Funds Transfer Authorization:

I, {FirstName} {Last Name}, authorize ELITE BOXING YOUTH CHAMPS, INC., to transfer electronic funds on a recurring basis from the checking, savings or credit card account I specified above for my membership dues. This authorization is to remain effective until ELITE BOXING YOUTH CHAMPS, INC. has collected all charges assessed in connection with the terms and conditions of this MEMBERSHIP AGREEMENT.

I acknowledge and agree that I will maintain membership and pay the dues specified below for a minimum term of {DurationCount}. I acknowledge and agree that I am liable for dues for the entire {DurationCount} Membership Term of this MEMBERSHIP AGREEMENT in the amount as stated herein regardless of usage or any change of circumstance.

Registration Fee

I agree to have a one-time, non-refundable Registration Fee of $100.00 (unless otherwise specified at the initiation of membership) paid by electronic funds transfer from the checking or savings account or automatic transfer from an accepted credit or debit card as specified above. I further understand and agree that this one-time, non-refundable registration fee applies to all new members or if my membership has been inactive for more than 364 calendar days.

Membership Terms of Payment

I, {FirstName} {Last Name}, have chosen to enroll in the following Class(es):

 

One Month Membership Term

I understand and agree that in addition to my Registration Fee, a non-refundable payment of $165.00 (unless otherwise specified at the initiation of membership) is due on the enrollment date of {FirstPaymentDueDate}. I further understand and agree that this non-refundable One Month MEMBERSHIP AGREEMENT shall end on {EndDate}. I am responsible for all charges billed or incurred prior to the completion on of this membership term.

Three Months Membership Term

 

I understand and agree that a non-refundable payment of $465.00 (unless otherwise specified at the initiation of membership) is due on the enrollment date of {FirstPaymentDueDate}. I further understand and agree that this non-refundable Three Months MEMBERSHIP AGREEMENT shall end on {EndDate}. I am responsible for all charges billed or incurred prior to the completion on of this membership term.

 

Six Months Membership Term

I understand and agree that the payment cycle will include the first and last month non-refundable payment of $270.00 (unless otherwise specified at the initiation of membership) which is due on the enrollment date . I further understand and agree that recurring monthly charges in the amount of $135.00 (unless otherwise specified at the initiation of membership)  will be transferred on the same day of each calendar month for a total of four months. Cancellation of Membership must be made in writing or in person thirty (30) business days before your next billing date. If less than (30) business days, you may be billed one more time. I further understand and agree that I am responsible for all charges billed or incurred prior to the cancellation request submission. This non-refundable Six Months MEMBERSHIP may also be paid in full for a total of $675.00 saving member $135 (unless otherwise specified at the initiation of membership). 

 

 

Specials/Promo Membership Term

 

I understand and agree to the payment cycle discussed at the initiation of membership. I further understand and agree that a recurring monthly charge in the amounts listed under your financial statement, will be transferred on the same day of each calendar month. Cancellation of Membership must be made in writing or in person thirty (30) business days before your next billing date. If less than (30) business days, you may be billed one more time. I further understand and agree that I am responsible for all charges billed or incurred prior to the cancellation request submission.

Personal Training

I understand and agree Personal Training is available upon request and availability. I understand and agree that payments for Personal Training are due at the time of training.

Cancellations and rescheduling must occur within 24 hours to avoid a $30.00 cancellation / rescheduling fee. All sessions must be redeemed by the same person within 30 days of first visit.

 

Cancellation Policy

Cancellation of Membership must be made in writing or in person thirty (30) business days before your next billing date. If less than (30) business days, you will be billed one more time. I further understand and agree that I am responsible for all charges billed or incurred prior to the cancellation request submission. No refunds will be given.

Termination Policy

In addition to any rights and remedies ELITE BOXING YOUTH CHAMPS, INC. may otherwise terminate this MEMBERSHIP AGREEMENT upon 5 (five) calendar days' written notice if I fail to comply with any of my obligations under this MEMBERSHIP AGREEMENT and do not cure any such failure within 5 (five) calendar days after receiving notice of such failure.

Transfer of Membership and Membership Holds

Membership may be transferred to someone else upon written approval of an ELITE BOXING YOUTH CHAMPS, INC. staff member.

Six months membership may be placed on a one time HOLD not to Exceed One Month. This HOLD may be less but must not to Exceed One Month.   

NOTE: For special situations and considerations, please speak to the owner of ELITE BOXING YOUTH CHAMPS, INC.

Other Fees and Payment Terms

All fees, schedules and rates are subject to change without notice. Changes in fees and rates may be applied upon membership renewal.

I understand and accept that a $15.00 Service Fee will be added to each DECLINED PAYMENT.

I shall pay a Drop-In Fee of $20.00 per Class if electronic funds transfer is declined.

Failure to attend the Classes does not relieve me of the obligation to pay the full membership rate for the Class(es) in which I am enrolled in.

If Family Member discount is in place and upon membership cancellation of any Family Member, remaining Family Member(s) fees and rates will be adjusted accordingly upon membership renewal.

Date of Signing:

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