FEMALES ONLY - BOXING CLASS 
We are excited to meet you, and  elated you chose to join our Female's only Saturday class. 
There is no experience needed- beginners / no boxing is welcomed! All fitness levels are welcome! 

Jass Boxing is a USA Boxing registered club, and all who wish to work out in our gym, will need to be registered with USA Boxing. Fear not... We are handling this!!  We just need you to fill out this form and we will do the rest. 

What you are being registered for: 
USA Boxing's Fitness membership is for people who want to work out in a USA Boxing registered gym and train like a boxer to get the fitness benefits. This membership allow you to work out, train with a coach, use heavy bags, speed bags punch mitts, etc. This membership does not allow sparring and is strictly a non-contact membership. 
This membership covers you under our club's secondary injury / accident insurance and good thru 12/31. 



What to bring / wear to class:
Wear comfortable clothing to work out
Sneakers / athletic shoe
We suggest a water bottle / drink
Sweat towel (if you wish) 

Parking:
It is recommended to park in the parking lots in downtown / near the Berwick Town Hall. We are a short 4 driveway walk from the town. 
There is limited parking in the driveway. We ask that you park to the left, or right of the driveway and leave the middle open.

Cost:
6 week session $125 (includes USA Fitness License, wraps and 6 week class)
Monthly after is $50/ month


If you have any questions- Please feel free to reach out! 

Jenn - 603-380-8279- or email me at info@jassboxing.org



Pre-Registration payment link (non-refundable): 

please visit www.jassboxing.org  [Female's Only Class] for the payment.



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Email *
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Date of Birth *
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Gender *
Phone Number *
Race / Ethnicity *
US Citizen  *
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Address,
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Mailing Address 
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Email Address *
Email address for License *
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Emergency Contact:  Name  *
Emergency Contact Phone *
Emergency Contact Email Address *
I understand there is a $50 non-refundable deposit. 
In the event that I change my mind. 
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Acknowledgement of Risk and Waiver of Liability I voluntarily assume the risk of injury, accident, death, loss, cost or damage to my person or property which might arise from my use of the gym, and I agree to hold harmless and release the gym and all affiliated corporations, and its officers, directors, board members, agents, employees, representatives, executors, and all others from any and all liability. I also release all of those mentioned and any others acting on their behalf from any responsibility or liability for any injury or damage to myself including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my participation in any activities or the use of any equipment at the gym during staffed or non-staffed hours.

General Statement of Program Objectives and Procedures  I understand that a physical fitness program may include exercises to build the cardio-respiratory system (heart and lungs), the musculoskeletal system (muscle endurance, strength and flexibility), and to improve body composition (decrease of body fat in individuals needing to loose fat, with an increase in muscle and bone). Exercise may include treadmill walking/running, bicycle riding, rowing machine exercise,  other such activities, weight lifting to improve muscular strength and endurance, and flexibility exercises to improve joint range of motion.

Description of Potential Risks I understand that the reaction of the heart, lung, and blood vessel system to such exercise cannot always be predicted with accuracy. I know there is a risk of certain abnormal changes occurring during or during exercise, which may include abnormalities of blood pressure or heart rate, in effect of functioning of the heart, and in rare instances heart attacks. Use of the weight lifting equipment, and engaging in heavy body calisthenics, can lead to musculoskeletal strains, pain, and injury if adequate warm-up, gradual progression, and safety procedures are not followed.

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Becoming more active is very safe for most people. However, some people should check with their Doctor before they start becoming much more physically active. If you are planning to become much more physically active than you are now.

I certify that I am in good physical health, and I am able to undertake and engage in the range of physical activities in which I choose to participate at the gym. I assume all responsibility for updating the facility with respect to any changes in my physical or mental condition and for reporting all injuries sustained at the facility to the gym staff. I understand and am aware that strength, flexibility, aerobic and anaerobic exercise, including the use of any equipment, is a potentially hazardous activity. I also understand that fitness activities involve a risk of injury and even death and that I am voluntarily participating in these activities and using equipment with knowledge of all the dangers involved. I do hereby agree to expressly assume and accept any and all risks of injury or death either accidental or otherwise. This waiver, release and indemnification agreement includes, without limitation, all injuries which may occur as a result of (a) my use of all amenities and equipment in the facility and my participation in any class, activity or personal training, (b) sudden unforeseen malfunctioning of any equipment and (c) my slipping or falling while in the facility, on the facility premises, including adjacent sidewalks and parking areas. I acknowledge that I have carefully read this waiver, release and indemnification agreement and fully understand that it is a full and complete release of all liability.

Agreements / Acknowledgment

I certify that I have read and understand all of the terms of the gym agreement

*
Required


WAIVER, RELEASE AND ASSUMPTION OF RISK


IN CONSIDERATION OF ME BEING ALLOWED TO PARTICIPATE IN ANY WAY IN ANY USA BOXING, INC. ACTIVITIES, I AGREE:

I understand the nature of USA Boxing, Inc. activities (sport of Olympic Style Boxing) and my experience and capabilities and believe I am qualified to participate in such activity and am in good health and proper physical condition. I further acknowledge that I am aware the activity will be conducted in facilities open to the public during the activity. I further agree and warrant that if I believe conditions to be unsafe, I will immediately discontinue further participation in the activity. I FULLY UNDERSTAND that: (a) USA Boxing, Inc. activities (Olympic Style Boxing) involve risks and dangers of SERIOUS BODILY INJURY, INCLUDING SICKNESS AND DISEASE, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ("Risks"); (b) these Risks and dangers may be caused by me or the actions or inactions of others participating in the activity, the condition in which the activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be other risks and social and economic losses either known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES incurred as a result of my participation in these activities. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS the USA Boxing, Inc. its clubs and LBCs, their respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessor of premises on which the activities take place (each considered one the "Releasees" herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the "Releasees" or otherwise, including negligent rescue operations and further agree that if, despite this release, I, or anyone on my behalf makes a claim against any of the Releasees named above, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM. IT IS HEREBY AGREED THAT in the event of a dispute between the undersigned (or another person acting on the undersigned's behalf) and USA Boxing, Inc. or any of the other Releasees, the exclusive venue and jurisdiction for any lawsuit arising out of such dispute shall be in the State Court of El Paso County, State of Colorado, unless federal jurisdiction applies, in which case the exclusive venue shall be in U.S. District Court in Denver, Colorado. GOVERNING LAW: The undersigned understands and agrees that this document is intended to be as broad and inclusive as permitted under applicable law and shall be governed by Colorado law. SEVERABILITY: If any provision of this document is determined to be invalid for any reason, such invalidity shall not affect the validity of any of the other provisions, which other provisions shall remain in full force and effect as if this document had been executed with the invalid provision eliminated.
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