This Waiver and Release Form (the “Form”) is entered into by the undersigned (the "Participant" or “Guardian” if the Participant is a minor) and StruXure Academy, including its officers, employees, agents, and representatives (collectively, “StruXure Academy”).
1. Assumption of Risk and Acknowledgement of Injuries
The Participant understands and acknowledges that athletic activities, including but not limited to training, practice, and recovery sessions, involve inherent risks of injury, both minor and serious. These risks include, but are not limited to, muscle strains, joint injuries, fractures, concussions, and other potential injuries arising from the activities.
By signing this Form, the Participant confirms that they have voluntarily chosen to participate in StruXure Academy programs and assume full responsibility for any and all risks of injury, regardless of severity, which may occur as a result of participation in any training or recovery activities.
The Participant agrees to take all necessary precautions and follow all instructions given by StruXure Academy’s staff to minimize risk. However, the Participant acknowledges that the possibility of injury cannot be entirely eliminated.
2. Release of Liability
The undersigned, on behalf of the Participant, hereby fully and unconditionally releases and discharges StruXure Academy, its officers, employees, agents, volunteers, and affiliates from any and all claims, demands, actions, causes of action, or liability of any kind, including but not limited to those arising out of any injuries or damages (physical, emotional, or property-related) that may occur during, or as a result of, participation in StruXure Academy’s programs, activities, or events.
This release includes, but is not limited to, any claim for negligence, gross negligence, or intentional misconduct by StruXure Academy or its representatives.
3. Medical Treatment
In the event of an emergency, the Participant consents to receive medical treatment as deemed necessary by a healthcare professional. The Participant understands that they are responsible for any medical costs incurred as a result of an injury or medical treatment.
4. Authorization for Use of Likeness
The undersigned hereby grants StruXure Academy the right to photograph, film, or record the Participant’s image, likeness, and/or voice during the course of participation in any of StruXure Academy’s programs, activities, or events.
The undersigned further grants StruXure Academy permission to use, distribute, or publicly display these photos, videos, and recordings in any form, including but not limited to, promotional materials, marketing campaigns, and on StruXure Academy’s website or social media platforms, without compensation or further approval.
5. Understanding and Voluntary Agreement
By signing this waiver, the undersigned confirms that they have read and fully understand the terms and conditions set forth in this Form, and agree to abide by them. The undersigned further affirms that they are executing this document voluntarily and without any duress or undue influence.
If the Participant is a minor, the undersigned, as the legal guardian of the minor, accepts responsibility for the minor’s participation and the terms of this waiver and release.
6. Severability
If any provision of this Form is found to be invalid or unenforceable by a court of law, the remainder of the Form shall remain in full force and effect.
Participant’s Full Name (Print): {name}
Date of Birth: {dob}
Address: {address}
Phone Number: {phone}
Email Address:
Emergency Contact Name: {contact_name}
Emergency Contact Phone Number: {contact_phone}
Guardian’s Name (if Participant is a minor):
Guardian’s Signature:
Date: {sign_date}
Participant Signature (if Participant is 18+):
This waiver must be signed and dated before the Participant may engage in any activities at StruXure Academy. Thank you for choosing StruXure Academy!
StruXure Academy