Gym Waiver | Elemental 5

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Gym Waiver

Participant's First name

Participant's Last name

Date of Birth

Emergency Contact Name

Phone

Email

Address

By checking this box I am agreeing to the terms and agreements outlined in the PDF labeled "Elemenal 5 Release". By completing this waiver I authorize this as my digital signature. View "Elemental 5 Release" PDF

By checking this box I am agreeing to te terms and conditions outlined in he PDF labeled "Elemental 5 Photo_Video Release". By completing this waiver I authorize this a my digital signature. View "Elemental 5 Photo_Video" Release

Parent / Gaurdian Full Name (Must be completed for participants under the age of 18)

Your Signature

Keep me updated!

Thanks for submitting!

info@elementalfive.com

719-838-2023

Elemental 5 LLC

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