MEDICAL RELEASE FORM
GUARDIAN (IF PARTICIPANT IS UNDER 18) OR EMERGENCY CONTACT INFO:
I, , being 18 years of age or older, do for myself or on behalf of my child participant, if
said is a minor, do hereby release, forever discharge and agree to hold harmless Ultimate Cheer and Dance Inc., their owners, directors, coaches and any employees thereof from any and all liabilities, claims, or demands of personal injury, sickness, or death as well as property damage and expenses of any nature whatsoever which may be incurred while in the facility.
Furthermore, I fully understand the risks associated with the usage of any and all equipment, class participation, and risks. I (or on behalf of my minor child participant) hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in classes. The undersigned further hereby agrees to hold Ultimate Cheer and Dance Inc. harmless, as a result of the negligent and willful or intentional acts of said participant, including expenses incurred attendant hereto.
I hereby grant permission to any licensed hospital and/or doctor to administer immediate medical treatment as deemed necessary to myself or my child should they be injured at any time during classes.
I understand that Ultimate Cheer and Dance Inc. staff at all times provides the maximum safety procedures and guidelines, and therefore cannot assume responsibility from any accidents or injuries that may occur. I understand that there is a risk or personal injury associated with performing this type of activity and assume risk of such injury. I have read and understood this release and voluntarily sign this document and participate in this activity or allow myself, my son/daughter to participate in this activity and hereby agree to this release.
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