Register for the Boxing Club

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  • Child's Information

  • Emergency Information

  • Person to Contact In Case Parents Can't Be Reached

  • Waiver Release

    I here give permission for my child(ren) to engage in all activities related to the Restoration Ministries, Inc. ("RMI") Harvey Boxing Club, including but not limited to training, sparring and fighting. I understand that training, sparring and fighting are all strenuous physical activities, and that injuries are to be expected. I state that my child is (I am) physically able to engage in all activities at the Club, and that I have fully disclosed above any allergies, other health or medical conditions, and medications. I here waive and release Restoration Ministries, Inc., its staff and volunteers from all liability, claims or causes of action that might arise from Boxing Club activities, including any related to an injury to my child(ren) or myself. In the event I cannot be reached in an emergency, I here give permission to RMI to select a physician or other healthcare provider to treat my child(ren). I agree that I shall be responsible for any and all expenses incurred for such medical care and treatments.

    I here give permission to RMI, its staff and volunteers, and third-party vendors (such as bus companies) to transport my child(ren) or myself in motor vehicles for Boxing Club activities, including transport between home and the Club. I here waive and release all liability, claims or causes of action that might arise from that transport, including any related to an injury to my child(ren) or myself. I here indemnify RMI, its staff and volunteers, third-party vendors, and all drivers for any and all damages arising from the transport of my child(ren) or myself.

    I here grant permission to RMI to photograph my child (excluding wards of the State) or me, and to use those photographs. RMI's use may include but is not limited to: publication or inclusion in online media, websites, brochures, posters, catalogs, handbooks, banners, and broadcast or print advertisement, produced either for free distribution, posting or for profit by RMI. I here waive and release all claims or causes of action arising from such photographs and their use, including claims for compensation.

    I have read and understood the foregoing Waiver and Release, and agree to its terms. Execution of this Waiver and Release is required to complete Boxing Club Registration.