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SECTION 1 — PARTICIPANT INFO

• Full Legal Name {name}
• Date of Birth {dob}

SECTION 2 — WAIVER TEXT

CHAMPION POWER BOXING LLC

ADULT MEMBERSHIP WAIVER, RELEASE & ASSUMPTION OF RISK

I voluntarily enroll as a member of Champion Power Boxing LLC (“CPB”) for ongoing boxing-based fitness training.

ASSUMPTION OF RISK

I acknowledge repeated participation carries inherent physical risks and voluntarily assume all such risks.

NO SPARRING WITHOUT SEPARATE WAIVER

This waiver does not authorize live sparring or head contact. A separate Adult Sparring Participation Waiver is required.

RELEASE & INDEMNIFICATION

I release CPB and agree to indemnify CPB for damages caused by my actions.

MEDICAL CERTIFICATION

I affirm I am medically fit or have consulted a physician.

CODE OF CONDUCT

I agree to comply with gym rules and acknowledge CPB may suspend or terminate participation.

PHOTO / VIDEO RELEASE

Permission granted.

GOVERNING LAW

Colorado law applies.

SECTION 3 — CHECKBOXES

I am 18 years or older

I understand this waiver does not permit sparring

I agree to the terms above

SECTION 4 — SIGNATURE

Electronic Signature Required