Clinic Waiver

Step 1 of 2 – Contact Information

Date*
MM slash DD slash YYYY
Participant Name*
First Last
Birthday
MM slash DD slash YYYY
Cell Phone*
Email*
USAT Membership Number
If you have an annual membership, please provide your membership number.
Please share any pertinent health information that would be helpful for us to be aware of for this clinic.
i.e. allergies, asthma, cardiac risks, panic attack or anxiety in the water, etc.
Emergency Contact Information*
Name, relationship, cell phone, work phone.

Waiver*
I acknowledge that triathlon, swimming, cycling, mountain biking, running and trail running training, strength training, bicycle fitting, indoor cycling, and general fitness training is demanding and carries with it potential for death, serious injury, and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THESE TRAINING PLANS, WORKOUTS, CLINICS, PRACTICES, PERFORMANCE TESTS, AND LABORATORY TESTS (Including lactate threshold/Functional Threshold Power testing). I certify that I am physically fit and have not been advised otherwise by a qualified health professional.

I hereby take the following action for Joel Young and Carolina Multisports, LLC, (CMS) their executors, administrators, partners, contractors, employees, heirs, next of kin, successors and assigns, or anyone else who might claim or sue on their behalf, and I expressly acknowledge that it is my intent to take these actions: (a) WAIVE, RELEASE, AND DISCHARGE FROM ANY AND ALL CLAIMS, LOSSES, OR LIABILITIES FOR DEATH, PERSONALLY INJURY, PARTIAL OR PERMANENT DISABILITY, PROPERTY DAMAGE, MEDICAL OR HOSPITAL BILLS, THEFT OR DAMAGES OF ANY KIND, INCLUDING ECONOMIC LOSSES AND LOSS AND/OR STOLEN ITEMS WHICH ARISE OUT OF OR RELATE TO MY PARTICIPATION IN THE PRESCRIBED TRAINING PLANS, TESTS, CLINICS, PRACTICES, AND PROGRAMS: Joel Young and CMS, their executors, administrators, partners, contractors, employees, heirs, next of kin, successors and assigns, or anyone else who might claim or sue on their behalf. I ALSO ASSUME ANY AND ALL OTHER RISKS associated with participating in fitness classes and/or athletic events including but not limited to falls, contact and/or crashes with other participants, effects of weather including lightning, heat and/or humidity, defective equipment, the condition of the roads and railroad crossings, water hazards, contact with the swimmers or boats, and any hazard that may be posed by spectators of volunteers all such risks being known and appreciated by me, and I further acknowledge that these risks include those that may be the negligence of the persons or entities mentioned above in paragraph (a) or other persons or entities; (b) I AGREE NOT TO SUE ANY OF THE PERSONS OR ENTITIES MENTIONED ABOVE IN PARAGRAPH (a) for any of the claims, losses, or liabilities that I have waived, released or discharged herein; and (c) I INDEMNIFY AND HOLD HARMLESS THE PERSONS AND ENTITIES MENTIONED IN PARAGRAPH (a) for any and all claims made or liabilities assessed against them as a result of (i) my actions or inaction’s, (ii) the actions, inactions or negligence of others including those parties hereby indemnified; (iii) the conditions of the facilities, equipment, vehicles, or areas where the event and/or class is being conducted; (iv) the Competitive Rules; or (v) any other harm caused by an occurrence related to athletic and/or fitness activities. I HEREBY AFFIRM THAT I AM EIGHTEEN (18) YEARS OF AGE OR OLDER. I HAVE READ THIS DOCUMENT, AGREE TO AND ACCEPT THE TERMS, AND UNDERSTAND ITS CONTENTS.

I agree to the waiver.
Equipment Acknowledgement*
CMS will not be responsible or liable for damage or loss that may occur to our clients’ or participants’ equipment while they are participating in any sponsored or supported events. This includes but is not limited to Triathlon training camps, clinics, practices, running, cycling, swimming or any other training or racing events and/or activities. CMS may provide transportation and/or housing of customer equipment. This includes but is not limited to items such as bicycles, run/swim gear, electronics & any other related or personal equipment. DURING SUCH TRANSPORTATION OR HOUSING. CMS WILL NOT BE LIABLE FOR ANY DAMAGE OR LOSS DUE TO ANY CIRCUMSTANCES.
I agree to the equipment acknowledgement.
Minor Release*
AND I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF THE ACTIVITY AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE’S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED, OR ALLEGED TO BE CAUSED, IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR’S BEHALF MAKES A CLAIMS AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR ANY COST THAT MAY OCCUR AS A RESULT OF ANY SUCH CLAIM.
I agree to the photography and/or video release.
Photography and/or Video Release
Participants involved in any activities offered by Joel Young and CMS may be photographed and/or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the CMS website or any editorial, promotional, social media, or advertising material produced and/or published by CMS.
I agree to the photography and/or video release.
Type full name for signature/Guardian Signature if under 18*
By typing my name, I confirm that I agree to the electronic submission of my this form and that I accept that the information provided constitutes a legally binding digital signature.

Clinic Waiver

Step 1 of 2 – Contact Information

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