MAD Speed - Registration

Participant Name

Parent/Guardian Name

Participant Date of Birth

Phone

Emergency Contact Name and Phone Number

Which Session are you attending?

Fall Session 2025 - Sep 8 - Oct 8 (M/W 4:00pm - 5:00pm)

T-Shirt Size

1. Acknowledgment of Risk

I, the undersigned parent/legal guardian, understand that participation in speed and agility training involves inherent risks, including but not limited to, muscle strains, sprains, broken bones, and other potential injuries. The training also requires activities at high levels of intensity that include running, jumping, bounding and other maximal output situations for participant bodies. I acknowledge that the trainers will take reasonable precautions to minimize these risks, but I voluntarily accept and assume full responsibility for these risks on behalf of my child.

2. Medical Authorization

In the event of an emergency, I authorize the speed training staff to obtain medical treatment for my child if I am not present or reachable. I agree to bear any costs associated with such treatment.

3. Health Condition

By allowing my child to participate, I confirm that they are physically fit and able to safely take part in all activities related to the speed training program. I agree to inform the program organizers of any medical conditions, allergies, or other health concerns in advance.

4. Release of Liability

In consideration of being allowed to participate in the speed training program, I hereby release, waive, and discharge the program organizers, trainers, coaches, facility owners, and all affiliated personnel from any and all claims, demands, or causes of action arising out of or related to any injury, loss, or damage sustained by my child during participation.

5. Indemnification

I agree to indemnify and hold harmless the above-mentioned parties from any claims or liabilities resulting from my child’s participation in the program, whether caused by negligence or otherwise.

6. Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of California

Media Release

I grant permission for my child's image or likeness to be used in program related media, including social media, promotional materials, and websites.

I do NOT grant permission for media use.

Parent/Guardian Electronic Signature

By typing my name above, I certify that I am the parent or legal guardian of the minor named above. I have read and fully understand this Waiver and Release of Liability. I voluntarily accept the terms stated above on behalf of my child. I further agree that by typing my name above, I am providing my electronic signature, which has the same legal force and effect as a handwritten signature under applicable law, including the U.S. Electronic Signatures in Global and National Commerce Act (E-SIGN)