REGISTER

Before you begin, please note all registrations will require personal information of the participant. To get familiar with all of our policies, you may visit the “HELP CENTRE” on this website.
Prices shown are already inclusive of the respective taxes and processing fees. ALL purchases are final and non-refundable.
Please ensure that ALL information is accurate and up-to-date

LET’S GET STARTED

PARTICIPANT'S NAME *

First / Last Name

SELECT PROGRAM TO PURCHASE

Purchase includes training kit, participation insurance and service subscription

PARTICIPANT INFORMATION

PARTICIPANT'S NAME *

First / Last Name

PARTICIPANT'S DATE OF BIRTH *

MM / DD/ YYYY

EMAIL *

ADDRESS

Address Line 1

City

State

LEGAL GUARDIAN INFORMATION

LEGAL GUARDIAN NAME *

First / Last Name

LEGAL GUARDIAN EMAIL *

LEGAL GUARDIAN ADDRESS

Address Line 1

City

State

INFORMED CONSENT TO DISCLOSE MEDICAL INFORMATION AND ASSUMPTION OF RISK AGREEMENT *

CLICK HERE TO REVIEW THE WAIVER FOR MEDICAL INFORMATION, ASSUMPTION OF RISKS AND WAIVE LEGAL RIGHTS

By proceeding with this registrations, I agree to disclose medical information to the best of my knowledge, as well as completing all the required participant waivers to waive legal rights

If at any point in time throughout this registration process you are uncomfortable with the terms and conditions, please do not proceed with the registration process.

MEDICAL INFORMATION

MEDICAL INFORMATION *

Disclosing medical information is a mandatory action for all participants in order to enroll in any of our programs

By completing the form below, you are agreeing to disclose personal/medical information about your child. Please ensure all information is accurate.
All information collected in this form, will be kept safe and not used for any other purpose other than the associated program

Please ensure that ALL information is accurate and up-to-date

Emergency contact person and/or family doctor will only be contacted if both legal guardians are not available/reachable

MEDICAL CONDITIONS (Check ALL that apply)

Asthma (Inhaler)
Allergies (Food or Other)
Difficulty Hearing
Diabetes
Taking medication for condition
Epi-Pen / Allerject
Heart Condition
Epilepsy
Blood Disorders
History of Concussions
Medical Alert Bracelet/Necklace
Prescription Eyewear
Permanent Physical Deficiency
Depression / Mood Disorder
Anxiety

EMERGENCY CONTACT NAME *

First

Last

EMERGENCY CONTACT TEL. NUMBER *

000-000-0000

FAMILY DOCTOR NAME *

First

Last

FAMILY DOCTOR CONTACT TEL. NUMBER *

000-000-0000

WAIVERS

INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT *

BY CLICKING THE BOX I AM CERTIFYING TO AGREE WITH ALL THE TERMS ABOVE AND WAIVE LEGAL RIGHTS

As a condition of participation in any activity at the AthELITE Centre, Participants must review the participation waiver and indicate your consent at the end this document.
I acknowledge that certain RISKS of INJURY are inherent in participation in sports and recreation activities. These types of risks can include, physical and/or mental stress due to various levels of training intensity or climate changes. It is highly recommended for participants to review the complete participation and release of liability waiver by clicking on the link below.
I acknowledge that there may be RULES and REGULATIONS applicable to the activity I wish to participate in, and that they are designed for enhancement of safety and protection of myself and other participants. I understand such RULES and REGULATIONS EXIST, and I undertake to abide by them.

I acknowledge that all activities require a level of FITNESS and HEALTH (physical, mental and emotional) Once the transaction is processed, one of our team members will be in contact with you for further details.

COMMITMENT OF PARTICIPATION AND RELEASE OF LIABILITY WAIVER *

BY CLICKING THE BOX I AM CERTIFYING TO AGREE WITH ALL THE TERMS ABOVE AND WAIVE LEGAL RIGHTS

I understand that this release discharges against the AthELITE Centre of use from any liability or claim that the child that I have registered above and myself, my heirs, or any personal representatives may have against the AthELITE Centre of use with respect to illness, death, medical treatment, or property damage that may arise from, or in connection to any services received from AthELITE Centre.

This liability waiver and release extends to the AthELITE Centre and/or facilities of use together with all owners, partners, employees and clients

VIDEO AND PHOTOGRAPHY USAGE CONSENT *

BY CLICKING THE BOX I AM CERTIFYING TO AGREE WITH ALL THE TERMS ABOVE AND WAIVE LEGAL RIGHTS

The AthELITE Centre will consistently capture video and photos where participants may or may not knowingly be in.
Such actions are solely intended for the purpose of marketing/education/social media content creation. I hereby grant The AthELITE Centre permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.
I understand and agree that all photos will become the property of The AthELITE Centre and will not be returned.

I hereby irrevocably authorize The AthELITE Centre to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

I hereby hold harmless, release, and forever discharge The AthELITE Centre from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

SIGNATURE *

Clear Signature

By signing here, I am certifying to agree with all the terms herein, and waive legal rights

ALL SALES ARE FINAL
Please make sure that all information provided is accurate, and proceed to completing the purchase

Total

Item Quantity Qty Total

There are no products selected.

SELECT PROGRAM TO PURCHASE – Membership / Subscription 1 $174.00

Subtotal

Total $0.00

$0.00

Coupon

PayPal Payment Terminal *

Card Number

Expiration Date

Security Code

Card Holder Name

LET’S GET STARTED

PARTICIPANT INFORMATION

LEGAL GUARDIAN INFORMATION

MEDICAL INFORMATION

WAIVERS

Contact info