Spring 2012 Indoor Class Registration

• First Name
• Last Name
• Email Address

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• Date of Birth
• Please select the day(s) that you would like to attend: Monday Tuesday Wednesday Thursday
• Please select the time you would like to attend: 3:30 4:30 5:30 6:30 7:30
• Sport Soccer Volleyball Basketball Lacrosse Track Softball/Baseball Multi-Sport
• Club / Team
• Waiver: TRIAD Waiver, Release, and Assumption of Risk Form This form is an important legal document. It explains the risks you (or your child) are assuming by participation in an exercise program. It is important that you read and understand it completely. After you have done so, check the box labeled “I AGREE” if you agree to the terms of this document. Waiver, Informed Consent, and Covenant Not to Sue You (as the legal guardian of the person you are signing up) have volunteered your child to participate in a physical conditioning program under the direction of the Training and Research Institute of Athletic Development (TRIAD), which will include, but may not be limited to, weight and/or resistance training, speed/agility training, conditioning, ball skills training, etc. In consideration of the TRIAD’s agreement to instruct, assist, and train your child, You do here and forever release and discharge and hereby hold harmless TRIAD, and their respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from. THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION. Assumption of Risk You recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. You acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure; fainting; disorders in heartbeat; heart attack; and, in rare instances, death. You understand that as a result of your child’s participation in a training program, your child could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life. You recognize that an examination by your physician must be obtained prior to involvement in this exercise program. You acknowledge and agree that you assume the risks associated with any and all activities and/or exercises in which your child might participate. You also agree to allow TRIAD to use images such as photographs and video of your child during training sessions for educational or promotional purposes in blog form, DVD or marketing pamphlets, brochures, emails, etc. YOU ACKNOWLEDGE THAT YOU HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY CLICKING THE “I AGREE” BUTTON BELOW THIS DOCUMENT, YOU AM WAIVING ANY RIGHT YOU OR YOUR CHILD’S SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST TRIAD, or OTHERS REFERRED TO IN THIS DOCUMENT FOR ANY NEGLIGENCE OR THAT OF OUR EMPLOYEES, AGENTS, OR CONTRACTORS. I AGREE

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