Waiver and Release Form

Email:______

CELL:______HOME: ______

WAIVER AND RELEASE FORM

Registration

Check to BAMM, PO Box 102, Westtown, Pa 19395

POLICY AS OF SEPTEMBER 2015

Sick Policy: Make up lessons are not guaranteed. Once notified of the illness your name will be placed on the makeup list and someone from BAMM will contact you if there is a make-up slot and time within the session to accommodate the missed lesson. This is not a guarantee, due to the pool space as well as instructor ratio.

Private Lesson Schedules: When booking your private or semi-private lessons you are required to make 2 lesson payments upfront and prior to the start of the scheduled lessons. If a cancellation occurs with less than 2 week notice given a $15.00 cancellation fee will be charged to cover facilities costs. If you decided to drop out of the class due to serious illness a credit of $5.00 for each group lesson and $15.for each private lesson paid in full. Each scenario will be evaluated on credit to be given.

Payment: ARE DUE PRIOR TO SESSION START PLEASE – all late payments will be assessed a $10.00 processing fee.

Child Readiness: Any child under the age of 4 years old must be enrolled in 2 private lessons and have the registration fee paid in full. The instructor will determine after the private lessons if the child is ready for group instruction.

Initial that you read and understood the above: ______

You, the client/participant, are aware that you are engaging in physical exercise or participating in a program which may use equipment, training and instruction, that could cause injury to you. You are voluntarily participating in these activities and assume all risks of injury that might result. You agree to waive any claims or rights you might otherwise have to sue me, your trainer/instructor, for injury to you as result of these activities. It is always advisable and recommended to consult your physician before undertaking this or any exercise program.

Family Name: ______Address: ______

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Participants Names: 1.______Age:______

2.______Age:______

3.______Age:______

4.______Age:______

Check YES or NO if you will allow BAMM to use your child or children photo for future marketing. ______

Medical information, if Applicable:

List any medication presently taken:

List any fractures or replacements:

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Signature of parent/guardianDate