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LION'S BOXING CLUB – WAIVER AND RELEASE OF LIABILITY

Participant Name: ________________________________________
Date of Birth: ___________ Age: _____
Parent/Guardian Name (if under 18): ___________________________
Phone: ___________________ Email: __________________________

Address: ___________________________________________________

ACKNOWLEDGMENT OF RISK & PARTICIPATION AGREEMENT

I understand that Lion’s Boxing Club, located at 1440 Oneida St., Appleton, WI, provides boxing-related training and conditioning programs for youth (ages 6 and up) and adults. These activities may include, but are not limited to:

• Physical workouts

• Pad work and drills

• Partner exercises

• Live sparring sessions with protective gear

• Strength and conditioning programs

I confirm that I (or my child/ward) am voluntarily participating in this program and acknowledge that participation in boxing and related fitness activities involves inherent risks, including but not limited to:

• Physical injury

• Concussions

• Bruising, sprains, or fractures

• Cardiovascular strain or other health-related issues

I further acknowledge that sparring is voluntary, and although protective equipment will be provided and encouraged (e.g., headgear, gloves, mouthguards), injuries can still occur, and I assume full legal responsibility for any injuries sustained during sparring or training activities.

MEDICAL CLEARANCE & RESPONSIBILITY

I certify that I (or my child/ward) have been medically cleared by a licensed physician to participate in physical and boxing-related activity. I understand that it is my responsibility to disclose any relevant medical conditions (including but not limited to asthma, heart conditions, past concussions, etc.) and to consult with a physician before engaging in any strenuous exercise.

I agree to notify staff immediately if any condition arises during training that might put myself (or my child) at risk.

RELEASE OF LIABILITY

In consideration of being allowed to participate in the programs and activities of Lion’s Boxing Club, I agree to the following:

• I hereby release, waive, discharge, and hold harmless Lion’s Boxing Club, its owners, instructors, volunteers, and staff from any and all liability, claims, demands, or causes of action for personal injury, illness, or property damage arising out of or connected to participation, including sparring activities.

• I understand that Lion’s Boxing Club is not liable for any injuries that occur from voluntary sparring, even when protective gear is used.

• I assume full responsibility for any risks of loss, property damage, or personal injury, including death, that may be sustained.

PHOTO & MEDIA RELEASE (Optional)

☐ I grant permission for my (or my child’s) image or likeness to be used in promotional material, including social media, website, or advertising.
☐ I do not grant permission.

EMERGENCY CONTACT

Name: ___________________________
Relationship: _____________________
Phone: __________________________

SIGNATURE

Participant Signature: ___________________________ Date: ____________
(If under 18)
Parent/Guardian Signature: ______________________ Date: ____________