Waiver Form FILL THE FOLLOWING FIELDS BELOW Name(Required) First Last Phone Number(Required)Please provide the best contact number including area codeDOB(Required)Please Provide your Date of Birth MM slash DD slash YYYY Any Medical History / Recent Surgery(Required) Emergency Contact(Required)Please Provide your emergency contact name and Number Today's Date(Required) MM slash DD slash YYYY Child Participant Name(Required) Terms and Conditions(Required)By Signing this Waiver I agree that I do hereby assume any and all risks involved in or arising from participation in any fitness classes and/or activities with Priscilla Tomkinson and/or Rebound Fit Club New Jersey, including without limitation, the risks of death or bodily injury as a result of my participation and/or my child's participation in classes and activities. I, the undersigned further agree that I am or we are physically fit to participate in the activities provided and agree not to sue Priscilla Tomkinson and/or Rebound Fit Club New Jersey, nor her/its affiliates on account of, or in connection with, any claims, causes of action, injuries, damages, costs or expenses arising out of my or our participation in any classes at any and all locations weather public or private. I, the undersigned, have read and understand this agreement and further understand that by making this agreement I surrender valuable rights. I also understand this waiver is valid indefinitely commencing on the date signed. Signature(Required)
