INFORMED CONTRACT FOR YOUTH PARTICIPATION
Thank you for choosing the services provided by Kickfit Lab. As a facility, we would like to ensure that our clients are provided with proper information prior to participation. We request your understanding and cooperation in maintaining your dependent’s and our safety and health by reading and signing the following INFORMED CONSENT AGREEMENT for your dependent.
I, (please print)_____________________ declare that I give my consent for my dependent to participate in the activities and/or services provided by Kickfit Lab.
I understand that different people have different capacities for participating in the various services and/or activities offered by Kickfit Lab. I assume full responsibility for my dependent during and after his/her participation in such activities and for his/her choices to use or apply at his/her own risk, any portion of the instruction or guidance that he/she receive while participating.
I understand that the risk involved in my dependent undertaking any of the activities is related to his/her own state of fitness or health, and the awareness, care, and skill with which he/she conducts themself in any of the activities provided by Kickfit Lab. I also understand that he/she is free to withdraw from, reduce, or modify his/her involvement in any of the activities at any time during a session and that he/she realizes that he/she should do so on recognition of any signs of physical discomfort and/or mental exhaustion.
I understand that my dependent’s behaviour outside the Kickfit Lab facility is my responsibility, and any potential injuries or risks they face outside the building are in my jurisdiction only. I understand that Kickfit Lab is not responsible for any risks occurring outside their facility. This includes but is not limited to icy conditions outside, vehicle damage, stolen items, etc.
I further understand that the possible risks involved for my dependent in participating in these activities may include but may not be limited to muscle, tendon, ligament, bone and joint soreness, strain, tear or rip; bruising, death; skin laceration; tears, cuts or punctures; shortness of breath of breath, dizziness, fainting, or unconsciousness; tightness in chest, bone breaks, discoloration, separations or fractures; fatigue; sweating; eye punctures; heart attack or stroke; aggravation of an existing or past injury; discomfort or problem with any other injury; discomfort or physical problems associated with physical activity and many other forms of physical discomfort and/or mental exhaustion.
In addition, I acknowledge that I have with my dependent inquired about the nature of any activity, program, or services that my dependent is not completely familiar with and my dependent and I have been informed of any inherent risks.
I have read the above list of possible risks associated with my dependent’s participation in the activities and/or services provided by Kickfit Lab and take full responsibility for my dependent and all potential consequences.
I consent to taking all of the above noted risks by having my dependent VOLUNTARILY PARTICIPATING in the activities and/or services provided by Kickfit Lab.
In order to offer all of our clients exceptional service, please read the following and sign to indicate your consent:
- We require at least 24 hours notice for any cancelled sessions. Should you be unable to provide us with at least 24 hours notice before your scheduled sessions, charges of $25.00 may be applicable (these fees are not refundable, and cannot be receipted).
- Please arrive on time for your session. Late arrivals may result in a reduction of your session length.
- All receipts will be issued only to the individual(s) trained, in their name, and for the dates and exact prices of the provided service. No exception will be made for this policy.
- The consumer (customer) will be able to terminate the contract at any time, free of charge, without penalty.
I declare that I have read, understood, and agree to the contents of this INFORMED CONSENT AGREEMENT in its entirety.
Name of dependent (please print): __________________________
Signature of Parent/Guardian: _____________________________ Witness: ________________________
Date of Consent: _____________________ Date of Witness: __________________