Liability Form

Gym & Fitness Liability Waiver

Please provide the gym member's info below. If the member is under 18 a parent or guardian must sign the liability form.

First Name

Last Name

Date of Birth

Phone

For the consideration of my gym membership and/or my child’s membership, I hereby completely and fully release Musa Muhammad's Academy of Boxing Science, and its owner(s), staff, volunteers, and other gyms members from any liability or fault for any and all injuries, illnesses or damages that I may incur directly or indirectly from boxing and/or workout activities at the gym. I also acknowledge that I understand the physical activities involved with boxing training may carry significant health risks, and I knowingly and voluntarily assume all risks. I agree to abide by the gym rules and regulations and understand that my membership may be revoked at any time if I fail to do so and that I will not receive a refund.

I have read and agree to the Membership Agreement described above.

Signature of Person 18+

Emergency Phone Number

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

Please note all payments are to be made via Cashapp to $dirul2019, please text Coach Musa directly when payment has been made to schedule your first session

Thank you for submitting your form, once payment is made please text Coach Musa to get your first session scheduled.