Waiver

Please sign the waiver below in order to complete your registration. 

I, as the parent or guardian (or the spouse, partner or legal representative thereof having the legal authority to agree to the terms and conditions in this form) of the below named child(ren) I, hereby consent to the participation of such Child(ren) in one or more classes, programs or parties offered by Super Moverz, LLC. I certify that each such Child is in good health and able to participate in all activities except to the extent I provide Super Moverz with information in writing setting forth any physical condition(s) of, and/or medications taken by, such Child and the extent to which such physical condition(s) and/or medications may limit his or her ability to participate in any activities in the class, camp or party. In case of an emergency affecting the Child, I hereby give permission for a physician or hospital designated by Super Moverz to administer treatment to the Child. I understand and agree that Super Moverz, LLC reserves the right to videotape, photograph and/or otherwise record any of its classes, programs, parties or other events and may use any such video, photograph or other sound or image in which the Child(ren) appears for training, promotional material or advertising purposes, including on the Super Moverz web site and brochures and that the sole rights to these videos, photographs, images and sounds belong to Super Moverz, LLC and/or Super Moverz, Franchising, LLC. I acknowledge, understand and agree, and will never contend otherwise, that the Location is that is independently owned and operated by a third party. In consideration of Super Moverz permitting the participation of the Child(ren) in one or more classes, programs or parties, I hereby acknowledge, understand and agree to the following: (i) I acknowledge and understand that there are physical risks associated with participation in, and/or being present at, the programs offered by Super Moverz, LLC; (ii) I, for the Child(ren), myself, any other parent or guardian (and any spouse, partner and legal representative thereof), relatives, heirs, and next of kin of the Child(ren) (referred to collectively as “We", “Us” or “Our”): (A) willingly assume the risks to the Child(ren), to Us, and to any other person(s), including but not limited to any caregiver(s), sibling(s) or child(ren) accompanying the Child(ren) to any program offered by Super Moverz (referred to collectively as the “Other Attendees”); (B) shall, and shall cause the Other

Attendees to, comply with all stated and customary terms, signs, rules and instructions as a condition for the Child(ren) participating in, and for Us and the Other Attendees permitted to be present at, any program offered at the by Super Moverz, LLC; (C) agree that Super Moverz, LLC disclaims, and We release, discharge, protect, defend, indemnify and hold harmless Super Moverz, LLC, its affiliates and related entities, officials, coaches, representatives, officers, directors, shareholders, employees, agents, franchisees, assigns and consultants (collectively, “Released Parties”) from and against, any and all claims, actions, liabilities, damages and expenses (including reasonable attorneys’ fees and court costs) whatsoever arising out of or in connection with the Child(ren)’s, Our and/or the Other Attendees’ participation in, and/or presence at, any program offered, including injury to, or illness of, the Child(ren), Us, or any of the Other Attendees, or for loss of or damage to any property (referred to collectively as “Claims”); (D) agree that: IN NO EVENT SHALL ANY OF THE RELEASED PARTIES BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, PUNITIVE, OR CONSEQUENTIAL DAMAGES OF ANY KIND WHATSOEVER EVEN IF ANY OF THE RELEASED PARTIES WERE PREVIOUSLY ADVISED OF THE POSSIBILITY OF SUCH DAMAGES AND REGARDLESS OF WHETHER SUCH DAMAGES ARISE IN CONTRACT, TORT, UNDER STATUTE, IN EQUITY, AT LAW, OR OTHERWISE IN CONNECTION WITH OR IN ANY WAY INCIDENT TO THE CHILD(REN)’S AND/OR THE OTHER ATTENDEES’ PARTICIPATION IN, AND/OR PRESENCE AT, ANY PROGRAM OFFERED BY SUPER MOVERZ AND/OR CAUSED BY ANY THIRD PARTIES; and (E) acknowledge and waive any and all claims of liability against the Released Parties related to an allergic reaction by any of Us in connection with food or activities by Super Moverz. I understand and agree to all the terms and conditions as stated in this Waiver Agreement. These terms and conditions (i) constitute the full understanding of myself and the Released Parties regarding the subject matter herein; (ii) cannot be modified except in writing signed by an authorized representative of Super Moverz, LLC; and (iii) shall apply to each and every class, camp or party in which the Child(ren), and any of my other children, participate, now and in the future, without regard to whether I sign a Waiver Agreement or any other agreement therefor unless, and until such time as, these terms and conditions are modified, and/or are superseded by subsequent terms and conditions, as set forth in writing and signed by an authorized representative of Super Moverz, LLC.

 
Name
Name
Child's Name (1) *
Child's Name (1)
Child's Name (2)
Child's Name (2)
Child's Name (3)
Child's Name (3)