Parent Name *

First Name

Last Name

Child Name *

First Name

Last Name

Child Date of Birth *

MM

DD

YYYY

Phone *

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What day would you like your free class? *

MM

DD

YYYY

Participation Acknowledgment *

I, the undersigned parent/guardian, give permission for my child to participate in fitness, dance, and wellness activities provided by 4AK Kids. I understand that these activities may include physical movement and exercise.

I Agree

Assumption of Risk *

I acknowledge that participation in physical activities involves inherent risks, including but not limited to the risk of injury. I voluntarily assume full responsibility for any risks, injuries, or damages that may occur as a result of participation.

I Agree

Release of Liability *

I hereby release and hold harmless 4AK Kids, Forever Aktive, its instructors, staff, and affiliates from any and all liability, claims, or demands for injuries or damages arising out of my child’s participation in any program or event.

I Agree

Medical Consent *

In the event of an emergency, I authorize 4AK Kids staff to seek medical treatment for my child. I understand that every effort will be made to contact me first. I accept responsibility for any medical expenses incurred.

I authorize

Photo/Video Release Consent *

I understand that 4AK Kids classes may be recorded and/or streamed live for promotional, educational, or social media purposes. By signing below, I grant permission for my child to appear in photos and/or videos taken during classes or events.

I DO give permission for my child to be recorded or photographed during live or recorded sessions.

Parental Presence Agreement *

I understand and agree that a parent or legal guardian (18+) must remain at the facility for the entire duration of the class. 4AK Kids staff are not responsible for the supervision or care of children outside of the class instruction time. I acknowledge that failure to comply may result in removal from the program.

I understand that i am recuired to remain at the facility for the entire duration of the class

Digital Signature *

First Name

Last Name

Date

MM

DD

YYYY