The Program :: Gridiron Training

- Spring 2012 ($600)

High School
(3 Days a week)

First Name Last Name Date of Birth
Gender
Shirt Size
School
Guardian First Name
Guardian Last Name
Guardian Phone Number
Email Confirm Email Cell Phone Number Address Line 1 Address Line 2 City State
Zip Card Type
Card Number CVV Code
Expiration

WAIVER AND RELEASE FROM LIABILITY 
 I understand that participating in the physical exercises, training and activities (the 
“Activities”) put on by The Program LLC (“The Program”) are potentially hazardous activities 
and that there are risks of injury associated with participating in the Activities.  I hereby 
acknowledge that as a participant in the Activities, I am participating at my own risk.  By 
signing this Waiver and Release From Liability,  I understand that I personally assume all of 
these risks and that I feel I am physically  and medically capable and properly trained to 
participate in the Activities.  I understand that a condition of my participation in the Activities is 
my agreement to knowingly and willingly sign this Waiver, and I agree to assume full 
responsibility for any risks, damages or injuries, known or unknown, which I might incur as the 
result of such participation.  I, on behalf of myself, my executors, administrators, heirs and 
assigns, hereby agree to hold harmless The Program and its heirs, successors and assigns, 
managers, members, employees, agents and representatives (“The Program Representatives”) 
from all liability of any type or nature on account of any injury, loss, claim or damage to my 
health, well-being or property resulting from this participation regardless of whether such 
injuries, losses, claims or damages are caused by The Program or The Program Representatives.

IN WITNESS WHEREOF, I have caused this Waiver and Release from Liability to be 
executed as of the date set forth below.