MVP Arena
Birthday Party Registration
& Waiver/Release Form

Name of Child:

 

DOB:        /     /

  Male       [  ]
  Female  [  ]

Address:

City:

State:

Zip:

Parent Home Telephone:         

 Additional Info:

Parent Cell Phone:

 

Parent Names:

e-mail address:

Emergency Contact Name:

Emergency Contact Phone:

 

By signing, parent or guardian agrees that he or she has read and agrees to the Parent/Guardian Waiver/Release.

Signature:_________________________________________________________ Date:_____/______/_______

Printed Name: _____________________________________________ Relationship to child: _______________

 

Parent/Guardian Waiver Release

As the parent or guardian of the above child, I fully understand that MVP Arena Staff members are neither physicians nor medical practitioners of any kind. With that in mind, I hereby release MVP Arena to render temporary first aid to my child in the event of any injury or illness, and if deemed necessary by the MVP Arena staff, to seek medical help and/or call an ambulance. I agree that I am aware that my son/daughter will be engaging in physical exercise involving sports and fitness that could cause injury to him or her. I also agree that my son/daughter is voluntarily participating in these activities and is assuming all risks of injury that might result. I hereby agree to waive any claims or rights that I might incur as a result of these activities. MVP Arena will make no evaluation or recommendation whether my son/daughter is physically fit for any physical activity. If my son/daughter has any physical condition that may impair his/her ability to engage in the activities, it is my responsibility to obtain a physician's statement describing any limitation to participate in this program. It is always advisable to consult a physician prior to undertaking any physical exercise program.