Training Option *

Please Select Your Train Option

Adult Fitness

Sports Performance Training

Basketball Skills Training

Participant Name *

First Name

Last Name

Phone *

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Date of Birth *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

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Parent/Guardian Name

If you are under the age of 18 years old please provide Parent Consent.

First Name

Last Name

Parent/Guardian Phone

If you are under the age of 18 years old please provide Parent Consent.

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Checkbox *

RELEASE OF LIABILITY: In consideration of being allowed to participate in any way with (Brown Performance Strength and Conditioning), its related events and activities, I,Camp Participant, the undersigned, acknowledge, appreciate, and agree that:1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the BPSC Staff immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS (Brown Performance Strength and Conditioning) their officers, officials, agents and/or employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessor’s of premises used for the activity ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Yes