5 STAR ACADEMIES, LLC. CONSENT & RELEASE FORM


 

RELEASE OF ALL CLAIMS, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT

  1. Hereby assert that I am mentally and physically capable of participating in the program(s). My participation in the program(s) is voluntary and I voluntarily agree to participate;
  2. Hereby assume full responsibility for and risk of personal injury and disability (physical and psychological) due to the negligence of the Releasees while on property owned by one or more of the Releasees or while participating in activities sponsored by one or more of the Releasees. This is a release of liability. By signing this, I am agreeing, among other things, not to bring any legal action of any kind against any of the Releasees. I acknowledge that I have read this agreement and voluntarily agree to the terms thereof;

ACKNOWLEDGEMENT OF RISK AND DANGER AND ASSUMPTION OF RISK I understand and am aware that the use of the 5 Star Academies, LLC. facilities and equipment has inherent and unanticipated and unknown risks and dangers that may cause injuries or death. I expressly assume all risk of personal injury, disability (physical or psychological) or death that may be sustained during my use of the facilities and equipment, its officers, director, agent and employees, defects in the facilities and equipment, the negligence of others and my own negligence or misuse.

RELEASE, COVENANT AND PROMISE NOT TO USE Hereby release, waive, discharge and covenant not to sue 5 Star Academies, LLC. and its affiliates, successors and predecessors, as well as officers, directors, employees, shareholders, attorneys, partners, agents, representatives, members, coaches, participants, volunteers, supervisors, and assigns of the foregoing (hereinafter collectively “Releasees”), of and from any and all liability to the undersigned, for any and all loss or damage, and any claim demand therefore, on account of any injury (physical or psychological) to the person or property of the undersigned, whether caused by negligence of any one or more of the Releasees or otherwise.

INDEMNIFICATION AGREEMENT Hereby agree to indemnify, hold harmless and exonerate the Releasees from any loss, liability, damage or cost they may incur due to the actions of the undersigned, as well as due to any damages sustained by the undersigned while on property owned by one or more of the Releasees .

PARENT/GUARDIAN/CONSERVATOR INDEMNIFICATION AGREEMENT In consideration of my child being permitted to use the 5 Star Academies, LLC. facilities and equipment I agree to indemnify and hold harmless this facility, and its Releasees of and from any claims, demands, liability, or judgments made by or on behalf of my child arising out of or during my child’s use of the 5 Star Academies, LLC. facilities and equipment.

INFORMED CONSENT In the event of physical injury resulting from evaluation procedures, equipment usage of equipment testing, initial first aid will be provided. If further medical attention is needed I must look to my own health insurance policies for further medical assistance. I understand the 5 Star Academies staff is relying on all information provided to me regarding my medical history and condition before allowing me to participate in any evaluation or training program. I certify the information to be true and correct.

PERMISSION TO PROVIDE MEDICAL TREATMENT/AGREEMENT

I HEREBY give permission for my son/daughter to undergo medical treatment for any injury or illness he/she may sustain or acquire while engaged in the 5 Star Academies Camps.. I understand that the personnel of the 5 Star Academies, LLC. use only those procedures, which are within their training, credentialing and scope of professional practice to prevent, care for and rehabilitate injuries.  In the event that more serious medical procedures are required, such as surgery or other invasive procedures, I understand attempts will be made to contact me for my consent.  I understand that if my child suffers a potentially life threatening injury or illness, and in the event that I am unable to be contacted within a reasonable period of time, that I authorize any duly licensed medical practitioner to perform such procedures as may be medically necessary to alleviate the problem.

I have had the opportunity to ask questions regarding this release and all of my questions have been answered to my satisfaction.  Having understood the above agreement, I freely agree to these terms of Permission to Provide Medical Treatment.

I acknowledge that the participant is under the age of 19.  I have reviewed the information provided and certify it to be true and correct.

Refund Policy
No refunds will be given once an athlete starts a 5 Star Academies program. If an athlete is unable to complete the training, due to an injury that occurred outside the 5 Star Academies, LLC. or other relevant circumstances that will not permit the athlete to finish, the remaining credit minus the cancellation fee of $75.00 will be kept on the account for no longer than one year from the start of the first workout. If after this time the athlete has not used his/her credit the remaining amount will than be forfeited.

If at any time an individual is unable to complete a performance training program due to an injury sustained during actual 5 Star Academies, LLC. component training, the prorated balance of their training fee may be refunded or maintained on account until the individual is able to complete the training.

Cash Refunds will not be given. Individuals granted refunds will receive a credit for the amount paid, which may be used towards the purchase of other 5 Star Academies, LLC. services.
If agreed to payment plan and fail to meet due dates, 5 Star Academies has the right to charge the credit card on file.

5 STAR ACADEMIES LLC. RULES AND REGULATIONS

All members of 5 Star Academies, including instructors, athletes, parents, siblings, relatives, or other third parties, are expected to observe and follow 5 Star Academies’s rules and regulations while on 5 Star’s premises, as detailed below:

  • Treat everyone with respect.
  • No provoking or participating in a disturbance, disruption, or fight.
  • No obscene, abusive, or offensive language.
  • No acting violently towards other members, staff, or anyone else on 5 Star’s premises.
  • No harassing other members, customers, or anyone else on 5 Star’s premises (including sexual harassment).
  • No stealing of company, including cash or other merchandise or equipment.
  • No behaving rudely to members, staff, or anyone else on 5 Star’s premises.
  • No possession of alcohol or drugs.
  • No coming to 5 Star under the influence of alcohol or drugs.
  • No gum chewing anywhere within the training portion of the facility (any non-lobby area).

Any damage or destruction of property, including but not limited to- breaking equipment, staining the turf, or damaging anything else within the premises- will be the sole responsibility of the person at fault to repair the damage and legal action may be brought against that person If they fail to do so in a timely manner.

Failure to abide by any of the above rules or if an employee of 5 Star Academies feels as though an athlete, parent, sibling, relative, or any other person has acted inappropriately, 5 Star Academies, as its sole discretion, may ask that person to leave immediately with no refund on their program or rental.

This consent and release form will remain in effect for any and all programs in which I take part at  5 Star Academies from today through one year from this date.