Registration Form

  • Emergency Contact Info

  • Medical Info

  • In consideration of being permitted to participate in fitness instruction, training, rehabilitation and food preparation by Urbancore, , which I acknowledge and agree to, on my own behalf, and on behalf of my personal representatives, heirs, assigns,executors, administrators, and next of kin, as follows: 1. I am aware and acknowledge that injury or death may result from fitness instruction, training, rehabilitation, food preparation and from the use of the premises and facilities or any equipment therein or thereon. 2. Upon entering the premises and facilities selected by Urbancore use of said premises and facilities shall constitute an acknowledgement that Urbancore find and accept such premises to be safe and reasonably suited for their intended purpose(s). 3. I hereby release Urbancore and its respective directors, officers, shareholders, employees, agents, contractors and their successors and assigns(effectively refereed as the Releasees) from and against any and all liability for any loss, damage, injury, expense, demand, or cause of action that I or members of the Urbancore team may suffer whether with respect to personal injury, death, damage to or destruction of property, theft, or otherwise that may arise as a result of participating in any event in, upon, or about the premises as a consequence of the use of the facilities and equipment. 4. I will indemnify and hold harmless the Releasees, collectively and individually, from any and all losses, liabilities, damages, demands, costs, and expenses that they may incur, for any reason whatsoever that may arise as a result of my participation in the contemplated activity, and my presence in, upon or about the premises.