Summer Youth Clinic's

When: Saturday August 23rd

Time: 10:00 AM - 10:50 AM

Age: 8-12

Parent Information

Parents First Name *

Parents Last Name *

Phone *

Email *

Childs Information

Childs Name *

Child's Age *

Youth Waiver

1. I agree that before my child participates, we will check the area, equipment, and facilities being used. If we notice anything that seems unsafe, we will let Uplifted Athletics know right away and my child will not take part until the issue is resolved. *

Yes I agree

2. I understand that even with the best supervision and safe training practices, there is always some risk involved in physical activity. While Uplifted Athletics takes every precaution to keep all participants safe, I acknowledge that my child may still be exposed to potential risks, including injury or accidents. These risks could be due to my child’s actions, the actions of others, or unexpected situations. I also understand there may be risks that are not known at this time. *

Yes I agree

3. I understand and accept the risks involved in my child’s participation, and I take full responsibility for any injury or harm that may occur, including in the rare case of serious injury or lasting effects. *

Yes I agree

4. I agree not to hold Uplifted Athletics, its staff, coaches, volunteers, sponsors, or any related parties responsible for any injuries, accidents, or damages that may happen during my child’s participation — even if they result from someone else’s actions or negligence. I understand this includes giving up the right to make any legal claims now or in the future related to such incidents. *

Yes I agree

I give Uplifted Athletics permission to take photos, videos, and recordings of my child during classes or events. These may be used by Uplifted Athletics for things like social media, websites, advertising, or other promotional materials. I understand that I won’t be paid for the use of these images or recordings, and I won’t have the right to review or approve them before they’re used. I also release Uplifted Athletics and its team from any claims related to the use of these images or recordings now or in the future. *

Yes I agree

Youth Physical Activity Readiness Questionnaire

1. Has your child's doctor ever said your child as a heart condition and that you should only engage in physical activity recommended by a doctor? *

Yes

2. Has your child felt pain in their chest when they engage in any physical activity? *

Yes

3. In the past month, has your child had chest pain when they were not engaging in physical activity? *

Yes

4. Does your child lose balance because of dizziness or do they ever lose consciousness? *

Yes

5. Does your child have any issues with their bones or joints (for example, back, knee, or hip) that could be made worse by a change in their physical activity? *

Yes

6. Is your child's doctor currently prescribing medication for their blood pressure or heart condition? *

Yes

7. Do you know of any other reasons why your child should not engage in physical activity? *

Yes

Yes to one or more questions:

Please consult with your doctor to get clearance that it is safe for you to become physically active at this current time and in your current state of health.

NO to all questions:

It is reasonably safe for you to participate in physical activity, gradually building up from your current ability level. A fitness appraisal can help determine your ability levels.

Next Steps:

After submitting this form, you will be automatically directed to our purchase portal where you can complete your purchase.

Please Note: Each session is limited to 18 participants. If a session reaches capacity, any additional sign-ups will be moved to the next available time slot, which will be opened accordingly. Sessions are also nonrefundable. Refunds will be processed as credit towards another session.

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.