New Client Waiver and Release

Date

Member ID

Athlete’s Name:

Date of Birth

School

Sport

Position:

Address

Athletes Phone:

Athlete’s Twitter:

Parent(s) Name(s):

Parent(s) Home #:

Parent(s) Cell #:

Parent(s) Work #:

Emergency Contact:

Emergency Contact: Phone

Signature

By submitting this form, the member acknowledges this is a binding agreement between GSP and its affiliates and agrees to adhere to the payment policy, membership plan, and GSP Waiver and release as described on the bottom of this document.

GSP WAIVER RELEASE & LIABILITY AUTHORIZATION

I hereby and forever discharge and release Georgia Sports Performance (GSP), their respective agents, owner, officers, successors and or assigns from any and all liabilities, claim demands, damages, actions or causes of actions the undersigned may incur or acquire during the course of his/her participation in involvement or training conducted by Georgia Sports Performance (GSP). This "Waiver and Release" is given for an in consideration for the opportunity to participate in training with Georgia Sports Performance (GSP). The undersigned warrants that he/she suffers from no minor or serious physical injury, illness or disability that would make him/her especially susceptible to injury or disability in performing any activity contemplated by this "Waiver and Release". The undersigned also warrants that he/she is psychically able to fully participate in the aforementioned training and that he/she fully comprehends and accepts all risks associated with participation. The Undersigned also agrees to disclose any and all medical conditions to GSP Coaches and/or Trainers that they should be made fully aware of and that said condition may inhibit some of his/her training at any time.

Student Athlete’s Name:

Date of Last Tetanus Immunization:

Allergies to medication:

List any medical conditions that GSP Should be aware of:

Client or Parent Guardian Signature: