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Waiver
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Name
*
First
Last
Date of Birth
*
Address
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Line 1
Line 2
City
State
Zip Code
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I am competing:
*
At the Event (5425 W. Vliet St.)
Virtually (via Zoom)
If you choose virtually you must have a Zoom platform.
Phone Number
*
Email
*
Will you need any modifications for your deadlift? If yes, please explain.
*
What size Unisex T-shirt?
*
Child Small
Child Medium
Child Large
XS-Adult
S-Adult
M-Adult
L-Adult
XL-Adult
XXL-Adult
I have enrolled in the Every Body Pulls Deadlift Fundraiser offered through FitPOWER LLC. I recognize that the program may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I acknowledge that my enrollment and subsequent participation is purely voluntary and in no way mandated by FitPOWER LLC. In consideration of my participation in this program, I hereby release FitPOWER LLC and its agents from any claims, demands, and causes of action as a result of my voluntary participation and enrollment. I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this program and I hereby release FitPOWER LLC and its agents from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I may incur, including death. I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS.
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**When you click SUBMIT you will be directed to the EventBrite page. Payment must be received for registration to be valid.**
Home
About Us
Memberships
Coaching Services
Martial Arts
>
Martial Art Class Schedule
Martial Art 30 Day Free Trial
Open Gym & Week Pass
Education
>
F.A.Q.
COVID Guidelines
Community
Martial Art Scholarship
Intro to Barbell
Community Power PT
Heal. Flow. Grow.
Shop
FitPOWER Apparel
Self Care & Doodads