Punch-A-Thon Puncher Registration

Name *

Date of Birth *

Phone Number *

Address (street number, name, city, state and zip code) *

E-mail Address *

Shirt Size *

How did you hear about this event? *

I want to punch as a.... *

Early Bird Puncher ($30.00) -before April 5

Late registration ($45.00)

Team Name *

I understand that I have enrolled in the Punch-A-Thon event offered through Pink Gloves Boxing- Austin, TX LLC and it’s personal trainers and affiliates. I recognize that the program may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I herby affirm that I am in good physical condition and do not suffer from any know disability or condition which would prevent or limit my participation in this event. I acknowledge that my enrollment and subsequent participation is purely voluntary and in no way mandated by Pink Gloves Boxing- Austin, TX LLC and it’s personal trainers and affiliates. In consideration of my participation in this event, I hereby release Pink Gloves Boxing- Austin, TX LLC and it’s personal trainers and affiliates from any claims, demands, and causes of action as a result of my voluntary participation and enrollment of the provided event. I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this event and I hereby release Pink Gloves Boxing Austin, TX LLC and it’s personal trainers and affiliates from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I may incur, including death. I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS. *

Agree

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