Athlete Inquiry Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Parents NameAthletes NameAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome PhoneWork PhoneCell Phonee-mailAthlete’s DOBAthletes AgeAthletes GradeHow did you hear about us?Newspaper AdTV CommercialHealth Club ReferralCampPostcardNewsletterWord of MouthWebsiteCoach ReferralAthlete ReferralSpecial Event / OtherAthlete Sports (Check all that apply)BaseballBasketballField HockeyFootballGolfGymnasticsHockeyLacrosseSoccerSoftballSwimmingTennisTrack Event(s)VolleyballWrestlingOtherAthlete SportsBased off of the sports you checked above, please number in order the sports your athlete participates in or would like to participate in. Your favorite sport should be marked as number 1.Athlete's Team of #1 SportAthlete’s Coach of #1 Sport1) Has your son / daughter recently suffered any injuries?2) What are your son’s / daughter’s goals? hear (Check / 3) What made you call or stop by today?4) Why is this important to you?5) Why do you think this is important to your child / athlete?Rev. March 2020 Medical & Promotional Release I, residing in the state of , acknowledge that I, , individually have voluntarily applied to participate in the Parisi Speed School training program. I acknowledge the risks and the potential risks of athletic training. Further, I understand that athletic training has limited ability to maintain social distancing and this creates other risks. However, I feel that the possible benefits to my child and I are greater than the risk assumed. I am aware that although Parisi Training Systems, its subsidiaries, Speed School Licensing and parent companies, its officers, directors, owners and/or employees make reasonable e!orts to make each athlete’s training a safe and productive experience, that there are inherent risks which occur as a result of such physical activity and lack of social distancing. I acknowledge that an athlete, when training, through no fault of his own, his trainer(s) or the facility may become injured for a variety reasons that are unavoidable. I represent that I am in good health and su!er from no physical impairment, which would limit my use of The Parisi Speed School’s facilities, virtual training or instruction. I further represent that I carry full and complete medical insurance coverage. I acknowledge that the Parisi Speed School has not and will not render any medical services including medical diagnosis of my physical condition. In consideration of being permitted by The Parisi Speed School to participate its in-person or virtual training program and to use its facilities when applicable, I hereby, intending to be legally bound for myself, my heirs and assigns, executors or administrators and/or guardian of my son/my daughter/my ward specifically agree that The Parisi Speed School, its officers, employees and agents shall not be liable for any claim, demand, cause of action of any kind whatsoever for, or on account of death, personal injury, illness, property damage or loss of any kind resulting from or related to my use of the facilities or participation in any athletic training, exercise or activity, whether virtual or in-person, within or outside the club premises, and I agree to hold The Speed Parisi School harmless from same. I herby waive any and all claims for any and all injuries or illness I may su!er under any circumstances, including but not limited to those claims arising from the negligence of the Parisi Speed School, Parisi Training Systems, its employees, agents, servants, invitees, co-members, contractors, or sub-contractors, employees or otherwise. Promotional Release In additional consideration of being permitted by The Parisi Speed School to participate in its education and training program and to use its facilities, I hereby permit The Parisi Speed School to use my name, image and likeness for promotional purposes. The Parisi Speed School’s promotional mediums include but are not limited to print, radio, video, television and the Internet. I acknowledge that I have read this release and waiver and fully understood its contents. I have been fully and completely advised of the potential dangers incidental to engaging in the activity and instruction of athlete training and I am fully aware of the legal consequences of signing this release. I voluntarily agree to the terms and conditions stated above. Athlete Signature Clear Signature Athlete Signature DateParent/Guardian Signature Clear Signature Parent/Guardian Signature DateSubmit