Transform Fitness Medical Release Form

To register, complete this form for each participant and click submit.
Sponsoring Organization:  Beacon Baptist Church
Address:  4800 Route 31, Clay, NY 13041  
Phone (315) 699-5900

Sponsor Coordinator:  Pastor Aaron Holt     (618) 534-1095


Description of Activity:  A Saturday morning group fitness ministry for males sixth grade and up. This ministry exists to build spiritual and pysical fitness by building intergenerational relationships and memorizinzing God's Word together.

Dates and location: June 26 - end of summer at Beacon Baptist church from 9:30 - 10:30 am.
Participant Information

 
 
 
 
 
 
 
 
 
Please select one option.
Please select one option.
 
 
Participation Agreement:
I acknowledge that participation in the activity described above involves risk to the Participant (and to Participant's parents or guardians, if Participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage and financial injury.  In consideration for the opportunity to participate in the actiivity described above (the "Activity"), the Participant (or parent/gurardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the Activity.  The Participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the Activity or during transporation to and from the Activity, as well as for any medical treatment rendered to the Participant that is authorized by the Sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to herinafter as the "Activity Sponsor").  Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless tha Activity Sponsor for any injury arising directly or indirectly out of the described Activity or transportation to and from the Activity, wheter such injury arises out of the negligence of the Activity Sponsor, the Participant, or otherwise.  If a dispute over this agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process.  If the Participant (or parent/gurardian) and the Activity Sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbirtation panel for resolution pursant to the rules of the American Arbitration Association.
 
 

Description

To register, complete this form for each participant and click submit.