Ninth Dimension Sports Circle

User Agreement

I agree to the Ninth Dimension Sports Circle Registration, Enrollment Policies and Requirements. I agree for my
child to Abide by the rules and regulations of the program and the use of the facility provided by the program. I understand that the failure
of my child to observe and abide by the rules and regulations may result in his/her being excluded from participating in the program.
I represent that my child is physically able to participate in the boxing program. I fully understand that his/her participatingmay entail the risk of physical injury. Write on the back of the page full detail of ANY AND ALL allergies, concerns, medical history, problems and conditions of your child that may affect their ability to participate in the program.
The program is developed with safety as the foundation. As with all sports, however, there is an element of risk inherent with participating in boxing.
For this reason, we ask that you provide your signed authorization to allow your child to participate in the program. Please let us know if you have any questions or concerns.
To reference Vion and Braces please refer to USA OFFICIAL RULEBOOK AND HISTORY Medical aptitude. Prohinitedconditions and/or conditional circumstances vision and braces.
Note: If a boxer is permitted, soft contact lens comes out and the boxer cannot continuue; the boxer losing the lens will lose by Referee Stopped Contest (RSC).
Boxers competing with braces waive the right to dental coverage under the USA Boxing insurance program.
In consideration of the child named being permitted to participate in the boxing programoffered the undersigned, for him or herself and for his or her successors, heirs, assigns, person representatives and in particular but without limitation for child names, hereby irrevocably: assumes full responsibility for and risk of bodily injury or propertydamage to or affecting named; waives and releases each of the Releases from all liability, claims, demands, losses or damage of any kind, and agrees to indemnify, save and hold harmless each of the Releases from any loss, liability, damage or cost they may incur whether due to the negligence of Ninth Dimension Sports Circle or any of its coaches, trainers, supervisors, directors, officers, organizers, employees, contractors, sponsors, agents and/or representatives, and (referred to throughout this document as the "Releases") or otherwise, including without limitation in connection with the presence of the child at any premises or location where any program is held before, during or after the hours during which the program is in progress.
I will be personally responsible for any financial cost incurred as a result of my child participation in the boxing program. Furthermore, I understand that Ninth Dimension Sports Circle assumes no liability for loss, misplaced, stolen and/or damaged personal property and I hereby agree to release Ninth Dimension Sports Circle from any such liability.


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Print child's full name                                                              Date of Birth


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Print parent's or authorized guardian's full name



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Signature of parent or legal guardian                                                                Date



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Street address



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City                                                     State                            Zip Code



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Parent or guardian telephone#

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Work telephone #

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Parent or guardian's home telephone#


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next of kin 2nd contact person emergency phone#

User Agreement

EXPLAIN IN FULL DETAIL ALLERGIES, CONCERNS, MEDICAL HISTORY AND PROBLEM RELATION TO YOUR CHILDS HEALTH
PRINT CHILDS COMPLETE NAME______________________________________________
ALLERGIES
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MEDICAL PROBLEMS, CONDITIONS OR PROBLEMS
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OTHER INFORMATION WE SHOULD KNOW ABOUT YOUR CHILD
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Your Signature                                                                    Date