INJURY WAIVER AND RELEASE OF LIABILITY FORM 

I HEREBY ASSUME ALL THE RISKS OF PARTICIPATING IN BOXING, KICKBOXING (hereinafter program) OR ANY OTHER FORM OF PHYSICAL ACTIVITY offered by Pittsburgh Punch, LLC, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. 

I CERTIFY that I am physically fit, have sufficiently prepared or trained for participation in the programs, activities or events offered by Pittsburgh Punch, LLC, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in these programs, activities, or events onsite / offsite Pittsburgh Punch, LLC premises. 

I ACKNOWLEDGE that this Injury Waiver and Release of Liability Form will be used by Pittsburgh Punch, LLC, its program instructors, and their affiliates, and that it will govern my actions and responsibilities at said programs, activities, or events. 

IN CONSIDERATION of my agreement with Pittsburgh Punch, LLC, and permitting me to participate in these programs, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: 

(A) I WAIVER, RELEASE AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from any Pittsburgh Punch, LLC program, activity, or event, THE FOLLOWING ENTITIES OR PERSONS: Pittsburgh Punch, LLC, and/or its directors, officers, employees, volunteers, representatives, and agents, the program instructors, activity or event holders, activity or event sponsors, activity or event volunteers: 

(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in these programs, activities, or events, whether caused by the negligence of release or otherwise. I ACKNOWLEDGE that Pittsburgh Punch, LLC and its directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific program, activity, or event on behalf of Pittsburgh Punch, LLC. 

I ACKNOWLEDGE that these programs, activities and events may involve a test of a person‘s physical and mental limits and may carry with it the potential for death and serious injury. The risks may include, but are not limited to, those caused by facilities, temperature, condition of participant, equipment, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of events, and lack of hydration. 

I HEREBY ACKNOWLEDGE that I am fully required to provide my own medical coverage and that Pittsburgh Punch, LLC will not be held liable for any expenses incurred for treatment of injuries while participating in these programs, activities, or events. 

The injury waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.  

PARENT / GUARDIAN WAIVER FOR MINORS (Under 18 years of age) 

The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting such capacity, has consented to his/her child or ward‘s participation in the programs, activity or events, and has agreed individually and on behalf of the child or ward, to the terms of the injury waiver and release of liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian.


Name *
Name
Check To Agree *