KNeticx, LLC
Agreement, Waiver, and Release

"*" indicates required fields

In consideration of participation in classes at KNeticx, LLC, I hereby waive, release, and discharge any and all claims arising out of or related to damage for personal injury, death, or property damage which I may have, or which may hereafter accrue to me, as a result of participation. I understand that this release is intended to discharge in advance KNeticx, its officers, employees, and agents from any and all liability arising out of or connected in any way with my participation in activities at this or any other location. I understand that participation involves an element of risk and danger and there is a danger of accidents. Knowing those risks, I hereby assume those risks. It is further agreed and understood that this waiver, release, and assumption of risk is to be binding on my heirs and assigns. I agree to indemnify and to hold harmless KNeticx, its officers, employees, and agents from any and all loss, liability, damage, cost, or expense which my heirs, assigns, or I may incur as the result of my death or any injury or property damage that I may sustain while participating in any activity at this or any other location, including any and all loss, liability, damage, cost, or expense arising out of negligence or carelessness on the part of those parties.

By participating I consent to images being taken of me by KNeticx to be used for any purpose including publications, websites, and advertising.

I have carefully read this agreement, waiver, and release and fully understand its contents. I am aware that this is a contract between myself and KNeticx and I sign it of my own free will.

Participant’s Signature*

Name*

First Last

Is the Participant is under 18 years old or has been appointed a guardian by a court?*

Yes

Consent of Guardian

(Fill this portion out if the Participant is under 18 years old or has been appointed a guardian by a court)

I am the parent or legal guardian of the participant listed above. I consent to the participant's participation in activities at this or any other location. I execute this Agreement, Waiver, and Release on the Participant’s behalf and understand and represent that this consent will bind the participant. I understand the physical requirements of participation and affirmatively state that the Participant is both physically and mentally able to participate in the activities. I agree to indemnify and to hold harmless KNeticx, its officers, employees, and agents from any and all loss, liability, damage, cost, or expense which the participant's heirs, assigns, or I may incur as the result of the participant's death or any injury or property damage that the participant may sustain while participating in any activity at this or any other location, including any and all loss, liability, damage, cost, or expense arising out of negligence or carelessness on the part of those parties.

I have carefully read this Agreement, Waiver, and Release and fully understand its contents. I am aware that this is a contract between myself as the guardian of the participant and KNeticx and I sign it of my own free will.

Guardian's Signature*

Name*

First Last

Relationship to Participant*

Hidden

Phone

This field is for validation purposes and should be left unchanged.

KNeticx, LLC Agreement, Waiver, and Release

Consent of Guardian

KNeticx, LLC
Agreement, Waiver, and Release