Sign up here! Name * First Name Last Name Email * Phone Number * (###) ### #### Date of Birth * MM DD YYYY Emergency Contact * First Name Last Name Phone Number * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country I hereby declare that all the above information is correct and accurate. I, being aware of my own health and physical condition, understand that my participation in any exercise program including but not limited to boxing, may be injurious to my health & the participation in physical activity with Kid Kelly Boxing & Fitness Inc. may result in physical harm. Having such knowledge, I hereby release Kid Kelly Boxing & Fitness Inc., its agents, and successors, from liability for accidental injury or illness that may result from my participation in the said physical activity or any other activity I decide to engage in at any Kid Kelly Boxing & Fitness Inc., place of business or exercise facility. I hereby assume all risk and /or liability, and consent to participate in said fitness/exercise program(s). I agree to be contacted by Kid Kelly Boxing & Fitness Inc. via phone number and/or email information I provided for membership and operations. By submitting this form, I consent to receive marketing text messages from Kid Kelly Boxing & Fitness Inc. at the number provided. I accept the no-refunds policy. I grant permission for the taking and use of the photograph(s) or electronic media images during classes for progress tracking, brand and class development. * I understand that this submission functions as my electronic signature to the terms. I accept I do not accept Parent/Legal Guardian Information If member is under 18 years old Name First Name Last Name Email Phone Number (###) ### #### Date of Birth MM DD YYYY I hereby declare that all the above information is correct and accurate. I, as the authorized guardian of the above mentioned individual, being aware of his/her health and physical condition, understand that his/her participation in any exercise program including but not limited to boxing, may be injurious to his/her health & the participation in physical activity with Kid Kelly Boxing & Fitness Inc. may result in physical harm. Having such knowledge, I hereby release Kid Kelly Boxing & Fitness Inc., its agents, and successors, from liability for accidental injury or illness that may result from the above mentioned individual's participation in the said physical activity or any other activity he/she engages in at any Kid Kelly Boxing & Fitness Inc., place of business or exercise facility. I hereby assume all risk and/or liability, and consent to his/her participation in said fitness/exercise program(s). I agree to be contacted by Kid Kelly Boxing & Fitness Inc. via phone number and/or email information I provided for membership and operations. By submitting this form, I consent to receive marketing text messages from Kid Kelly Boxing & Fitness Inc. at the number provided. I accept the no-refunds policy. I grant permission for the taking and use of the photograph(s) or electronic media images during classes for progress tracking, brand and class development. I understand that this submission functions as my electronic signature to the terms. I accept I do not accept Thank you!