Athlete Name *
Athlete Name
Mailing Address *
Mailing Address
Athlete Date of Birth *
Athlete Date of Birth
Parent Or Guardian Name (17 and Under)
Parent Or Guardian Name (17 and Under)
Cell Phone *
Cell Phone
I understand the use of photo and video for marketing purposes. All youth will be aware if photo or video is being taken. I understand that I must notify a Rise staff member if I do not want my child in photo or video. *
I consent to my child’s participation in a fitness program at Rise Athletics & Wellness. I am aware that there are risks associated with participation in a fitness program, including the risk of injury, and I consent to my child’s participation in spite of such risks. I acknowledge that it is my responsibility to advise Rise Athletics & Wellness of any medical or other conditions that may affect my child’s participation in the fitness program. In the event that my child requires medical attention, I consent to my child being transported to the nearest emergency centre, including by ambulance if necessary, and accept that I am responsible for any costs of such ambulance service. I have read this Parental Consent Form and understand and accept the terms. *
Please note that all participants must be attentive and remain in the designated area as shown by the coach at all times. Inability to remain in designated areas or follow instructions from coach will result in removal from the program. This is necessary strictly for the safety of all youth involved. *