Hello there!  Thank you for taking time to complete this Inquiry and Medical Release Form.  All of the information you provide us with is strictly confidential, and is only used to get to know you and your athlete and create the best training program for your needs.  By clicking the submit button at the bottom of this form once you complete the information, you are confirming that you agree, understand and have read the Standard Medical Release Form and Promotional Release Form.

Contact Information
Parents Name *
Parents Name
Athletes Name *
Athletes Name
Address *
Address
Parents Home Phone
Parents Home Phone
Parents Cell Phone *
Parents Cell Phone
Athlete Date of Birth *
Athlete Date of Birth
Social Media Contact Information
We use this to communicate and share info on social media with parents and athletes, as well as tag and share posts of our athlete's accomplishments.
Example: facebook.com/bob.smith
Example: instagram.com/bobsmith/
Example: twitter.com/bobsmith
How Did you here about us?
Check all that apply *
Athlete Sports Played or would like to Participate in
Check all that apply *
eg: 1. Football 2. Lacrosse 3. Soccer
Getting to know your athlete
Would you prefer to have your son/daughter train in small group setting with personalized program, or in large group setting? *
Which days work best for your athlete to train
Check all that apply
Standard Medical Release
I acknowledge that I, individually, have voluntarily applied to participate in the Parisi Speed School training program. I acknowledge the risks and the potential risks of athletic training. However, I feel that the possible benefits to me and my child are greater than the risk assumed. I am aware that although The Parisi Speed School Franchise, its subsidiaries, Speed School Franchisor and parent companies, its officers, directors, owners and/or employees make reasonable efforts to make each athlete’s training a safe and productive experience, that there are inherent risks which occur as a result of such physical activity. I acknowledge that an athlete, when training, through no fault of his own, his trainer(s) or the facility may become injured for a variety reasons that are unavoidable. I represent that I am in good health and suffer from no physical impairment, which would limit my use of The Parisi Speed School’s facilities or instruction. I further represent that I carry full and complete medical insurance coverage. I acknowledge that the Parisi Speed School has not and will not render any medical services including medical diagnosis of my physical condition. In consideration of being permitted by The Parisi Speed School to participate its training program and to use its facilities, I hereby, intending to be legally bound for myself, my heirs and assigns, executors or administrators and/or guardian of my son/my daughter/my ward specifically agree that The Parisi Speed School, its officers, employees and agents shall not be liable for any claim, demand, cause of action of any kind whatsoever for, or on account of death, personal injury, property damage or loss of any kind resulting from or related to my use of the facilities or participation in any athletic training, exercise or activity within or outside the club premises, and I agree to hold The Speed Parisi School Franchise harmless from same. I herby waive any and all claims for any and all injuries I may suffer under any circumstances, including but not limited to those claims arising from the negligence of the Parisi Speed School Franchise, Parisi Speed School Franchisor its employees, agents, servants, invitees, co-members, contractors, or sub-contractors, employees or otherwise.
Promotional Release
In additional consideration of being permitted by The Parisi Speed School to participate in its training program and to use its facilities, I hereby permit The Parisi Speed School to use my name, image and likeness for promotional purposes limited to its athletic training programs and facilities. The Parisi Speed School’s promotional mediums include but are not limited to print, radio, video, television and the Internet. I acknowledge that I have read this release and waiver and fully understood its contents. I have been fully and completely advised of the potential dangers incidental to engaging in the activity and instruction of athlete training and I am fully aware of the legal consequences of signing this release. I voluntarily agree to the terms and conditions stated above.
Electronic Signature
By printing your name below, you acknowledge you agree to the terms set forth in this document.
Parent Name *
Parent Name
Date *
Date
Athlete Name
Athlete Name
Date
Date