REGISTRATION FORM & WAIVER
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TODAY'S DATE *
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NAME (LAST, FIRST, MI) *
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POSITION(S)
HOW DID YOU HEAR ABOUT US? *
MAILING ADDRESS *
PHONE NUMBER *
DATE OF BIRTH *
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AGE *
GENDER *
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MARITAL STATUS
Clear selection
PRIMARY GOAL *
EMERGENCY CONTACT (NAME & PHONE) *
RELEASE AND WAIVER OF LIABILITY NOTICE: THIS RELEASE AND WAIVER AFFECTS YOUR LEGAL RIGHTS.PLEASE READ IT VERY CAREFULLY AND UNDERSTAND IT BEFORE INITIALING OR SIGNING IT.Parent/Legal Guardian should initial and sign on behalf of participating Minor after discussing each section with him/her, indicating that both the Minor and the Parent/Legal Guardian agree to each section, on behalf of myself, spouse, children, next of kin, heirs, guardians, assigns, personal representatives and estate (or those of the Minor if I am his/her Legal Guardian), and in consideration of the Services (as defined below) provided by Tactical Strength Hawaii, LLC and/or its agents, understand and agree to be bound by the terms of this Release and Waiver of Liability (hereinafter “Release”).  Definitions“Services” shall mean any and all manner of goods and services offered by Tactical Strength Hawaii, LLC or any other Released Party. These services, which may take the form of training, treatment, consulting, and the like, expressly include but are not limited to: evaluations; reconditioning; performance planning; performance training (including strength & conditioning training, speed & quickness training, plyometric training, and the like); recovery and regeneration training; sports nutrition consultation; supplement and nutrition provision; any consultation related to any item in this list; injury reduction and treatment; technical and tactical instruction; performance enhancement.“Training” shall mean any act, action, or other activity required of you or carried out by you in relation to the Services. “Released Parties” shall mean Darin Yap, Tactical Strength Hawaii, LLC, and their respective officers, directors, shareholders, members, managers, insurers, partners, employees, employers, agents, successors, contractors, assigns, affiliates, parent corporations, affiliated corporations, and subsidiary corporations. Terms and Provisions This Release governs all rights and liabilities relating, in any way, to the Services.  I understand and acknowledge there are inherent risks involved with participation in sporting events and other strenuous physical activity, including Training, and that no amount of care, caution, instruction or expertise can eliminate all of these risks.  Risks include, but are not limited to:  fractures; sprain, strains, tears of ligaments/tendons/muscles; adverse allergic reactions; hematoma; laceration; heart failure; stroke; anaphylactic shock; herniated discs; aneurysm; traumatic brain injury; other serious permanent physical/psychological injury, paralysis and/or even death. *
Required
By participating in the Training and/or receiving Services, I consent to the use of any photographs, pictures, film or videotape taken of me or provided by me for publicity, promotion, television, websites or any other use, and I expressly waive any right of privacy, compensation, copyright or other ownership right connected to same. *
Required
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS of participation in Training, including, without limitation, risk arising from or relating in any way to the condition of the facilities, equipment, fields, and surrounding premises, the actions of persons other than myself, my own actions, and travel to and from the Training. *
Required
I UNDERSTAND THAT THE RELEASED PARTIES MAKE NO WARRANTIES and shall in no event be responsible or liable for the defective or dangerous condition of the facilities, equipment, fields, and surrounding premises. *
Required
I AGREE THAT THE RELEASED PARTIES SHALL NOT BE LIABLE for any claims, demands, injuries, damages, actions, or causes of action that arise in whole or in part due to the acts or omissions of the Released Parties. *
Required
FURTHERMORE, I FOREVER RELEASE AND DISCHARGE, AND AGREE TO INDEMNIFY AND HOLD HARMLESS, the Released Parties from and in relation to all claims, demands, injuries, damages, actions, or causes of action that arise from or relate in any way to my participation in the Training. *
Required
I WARRANT AND REPRESENT that I have no health conditions or defects that would prevent me from participating safely in the Training, that I have consulted and been cleared by a medical doctor in relation to participate in the Training, and that I am otherwise sufficiently fit and healthy to participate in the Training. *
Required
IN NO EVENT SHALL A RELEASED PARTY BE LIABLE TO ME FOR ANY REASON AND UPON ANY CAUSE OF ACTION IN EXCESS OF THE AMOUNT ACTUALLY PAID BY ME TO TACTICAL STRENGTH & CONDITIONING, LLC DURING THE TWELVE MONTHS IMMEDIATELY PRECEDING MY ASSERTION OF SUCH CLAIM. THIS LIMITATION APPLIES TO ALL CAUSES OF ACTION IN THE AGGREGATE, INCLUDING, WITHOUT LIMITATION, BREACH OF CONTRACT, BREACH OF WARRANTY, NEGLIGENCE, GROSS NEGLIGENCE, STRICT LIABILITY, MISREPRESENTATIONS AND/OR OTHER TORTS. *
Required
I acknowledge that I have received valuable consideration in relation to my execution of this Agreement, which I understand to be a prerequisite to my receipt of Services. *
Required
If any paragraph, subparagraph, sentence or clause of this Agreement shall be adjudged illegal, invalid or unenforceable, the balance of the Agreement shall remain in full force and effect. This Agreement shall be construed and interpreted under Hawai’i law. Any lawsuit or claim arising from or relating in any way to Training, Services, and/or this Agreement shall be brought, if at all, in Honolulu, Hawai’i. Finally, I understand that this Agreement shall be of full force and effect as to any and all Services I receive from the Released Parties, without regard to the date or timing of such service. AS EVIDENCED BY MY SIGNATURE BELOW, I AGREE THAT I HAVE READ THIS RELEASE, I UNDERSTAND ITS TERMS, AND THAT I AM VOLUNTARILY RELINQUISHING SUBSTANTIAL RIGHTS BY SIGNING IT. I ACKNOWLEDGE THAT I AM SIGNING THIS RELEASE ON MY OWN FREE WILL.   *
MEDICAL HISTORY: HAVE YOU HAD AN INJURY BEFORE? *
IF YES, PLEASE LIST
HAVE YOU HAD SURGERY RELATED TO YOUR INJURY? *
DO YOU HAVE OR HAVE HAD A MEDICAL CONDITION THAT WOULD AFFECT EXERCISE? *
IF YES, PLEASE EXPLAIN
DO YOU HAVE ANY ALLERGIES? IF SO, PLEASE LIST
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A copy of your responses will be emailed to the address you provided.
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