Child's Information

Date of Birth
Dominant Hand*
  • Right
  • Left
Event Time*
  • 9:00AM-12:30PM
Country
Email*
Confirm Email*
Phone (xxx-xxx-xxxx)

Guardian Information

We will send updates and reminders prior to the event, so please include the e-mail address you check most often.

Guardian #1 Name/ Relationship
Guardian #1 Cell Phone (000-000-0000)
Guardian #1 E-Mail
Guardian #2 Name/ Relationship
Guardian #2 Cell Phone (000-000-0000)
Guardian #2 E-Mail
Lives with
Emergency Contact Name/ Relationship
Emergency Phone (000-000-0000)

Medical Information

Medical Conditions
Allergies
Dietary Restrictions
Medications

Liability Waiver

I do hereby assume full responsibility for any and all damages, injuries (including death), or losses that my child may sustain or incur, if any, while attending, practicing, participating or witnessing in any club exercise program, sport or physical activity occurring in or about the club premises or at any offsite location.  I hereby assume full risk, waive all claims and release and hold Sow Good Now, and the Andrew L. Hicks, Jr. Foundation, its instructors, or partners of said program or event, individually or otherwise, harmless for any and all claims for injuries or damages.

 

I am fully aware and understand that the club does not have on or about the club premises, or employ or contract with any medical services, provisions for ordinary or emergency medical services.

 

In consideration of my child’s participation in and the use of the Club’s facilities, I hereby release and covenant not to sue the Club, its owners, shareholders, directors, officers, employees, representatives, agents, and lessees from any and all claims resulting from any physical injury that may occur to my child while participating in any program or event sponsored by the Warrior Guides or the Andrew L. Hicks, Jr. Foundation.

 

I have read and fully understand the above release/waiver and fully understand that I have given up substantial rights by signing this waiver voluntarily.

 

Parent or guardians must type name as signature.

Liability Release Signature*

COVID19 Waiver

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.The Andrew L. Hicks Jr. Foundation has put in place preventative measures to reduce the spread of COVID-19; however, the Foundationcannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the Eventcould increaseyour risk and your child(ren)’s risk of contracting COVID-19.

 

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the Eventand that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Eventmay result from the actions, omissions, or negligence of myself and others, including, but not limited to, Eventemployees, volunteers, and program participants and their families.I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the Eventor participation in Eventprogramming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue,discharge, and hold harmless the Andrew L. Hicks Jr. Foundation, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Andrew L. Hicks Jr. Foundation, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Andrew L. Hicks Event program.

Photo/Video Permission

I hereby grant permission to the Andrew L. Hicks, Jr. Foundation to photograph my image and/or that of my minor child and to edit, crop, or retouch such photographs.  I consent to permit those photographs to be used by the Andrew L. Hicks, Jr. Foundation for any purpose, including education and advertisement purposes, and in any medium including print and electronic.

 

Parent or Guardian must type name as signature.

Photo Permission Signature*

IMPORTANT NOTE

ANYONE WHO REGISTERS IS EXPECTED TO ATTEND, OR CALL TO CANCEL AT LEAST ONE DAY BEFORE.

 

IF YOU DO NOT ATTEND, OR CONTACT US, YOU ARE A "NO SHOW" AND WILL NOT BE PERMITTED TO ATTEND ANOTHER OPEN EVENT THIS YEAR.

 

WE LOSE MONEY ON BUSING AND FOOD, WHEN CHILDREN REGISTER BUT DO NOT ATTEND.

 

Thank you, for your cooperation.

 

 

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