AGES 19-21 ONLY: report-card exempt. Required intake and staff approval still apply. Age 18 or younger must use the report-card signup.

Participant Waiver, Release of Liability, and Media Consent Form

Participant Information:

Name:              {name}
Date of Birth:    {dob}
Phone:             {phone}
Email (if any): 

Parent/Guardian Information:

Name:           
Relationship:
Phone:           
Email:           

Address: {address}

Emergency Contact (if different from above):

Name: 
Phone:

I, the undersigned parent/legal guardian of the minor participant, hereby acknowledge, appreciate, and agree to the following:

1. Consent to Participate: I give my permission, or my minor child, permission to participate in the programs, training, and related activities conducted by Bronx Legends Boxing Inc. and NYPD Fighting Finest Inc. at 1761 Walton Ave, Bronx, NY 10453.

2. Assumption of Risk: I understand that boxing and physical fitness activities involve inherent risks. I voluntarily assume all risks associated with my child’s participation.

3. Waiver and Release of Liability: I release and hold harmless Bronx Legends Boxing Inc., NYPD Fighting Finest Inc., and their officers, directors, agents, volunteers, staff, and sponsors from any liability or claims related to injuries or losses sustained by myself or my child during participation.

4. Insurance Acknowledgment: I understand that this is a free program and that NYPD Fighting Finest Inc. maintains general insurance, but I remain responsible for myself or my child’s individual medical needs.

5. Health Representation: I certify that I or my child is physically fit and has no condition preventing safe participation in gym activities.

6. Media Release: I grant permission for Bronx Legends Boxing Inc. and NYPD Fighting Finest Inc. to use my or my child’s image, likeness, voice, and/or name in photos, videos, or media coverage for promotional or educational purposes.

Signature of Parent/Guardian (if participant is minor)

Date: {sign_date}

*Populate with "N/A" if participant is not minor)

Signature of Participant:

{name}
Date: {sign_date}