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Call or Text 380-210-4959
Neighborhood Boxing Club
Date of Birth
Please specify anything injuries we should know about
I declare that the info I’ve provided is accurate & complete
ASSUMPTION OF RISK, CONSENT, RELEASE, AND WAIVER: In consideration of mutual agreements by which I and/or my guests will use the premises of Neighborhood Boxing Club LLC which I acknowledge to be beneficial to me, I acknowledge and agree to the following: l warrant and represent that I am in appropriate physical condition for the physical. activities in which I will participate and that such physical activities, even noncontact activities, carry a risk of serious physical injury including substantial and permanent injuries, and/or death, and I knowingly and voluntarily assume those risks and waive in advance any claim of liability resulting from those risks. On my own behalf and on behalf of my representatives, my estate, and all persons claiming through me directly or derivatively, I hereby agree to hold harmless, release, and discharge in advance Neighborhood Boxing Club LLC and their respective owners, officers, 'employees, affiliate companies, and all other participants and nonparticipants associated with those named entities (hereinafter the "Club") from any injury that I may receive whether or not from the negligent or intentional acts of those' . persons released. Furthermore, I agree on my own behalf and behalf of my representatives, estate, successors and assigns to defend the Club from and against any and all claims and liability that may arise by reason of any injury or death I or any guest of mine may sustain from physical activities at the facilities of the Neighborhood Boxing Club LLC, whether caused by an intentional act, or by negligence, or otherwise without limitation. This agreement to defend includes any claim, action or liability whatsoever, regardless of whether the claim is made, without limitation, by me, by someone on my behalf or by someone whose claim is derived from my injury or death. l acknowledge and agree (I) that it is my responsibility to cover any medical bills that I may incur and to cover myself with any medical insurance I may deem appropriate and (2) that I will not and cannot make any claim for medical coverage resulting from any injury or death incurred by me at the facilities of the Neighborhood Boxing Club LLC . The Club shall not be liable for any loss or theft of my personal property. I also specifically agree that the Club shall not be responsible for all such personal or property injuries, damages, loss or theft, even in the event of negligence, fault or failure to use due care on the part of the Club, and whether such negligence, fault, or failure to use due care is present at the signing of this Agreement or takes place in the future.
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