Let's talk | Viva By Design

Athlete First name

Athlete Last name

Birthday

Month

Day

Year

Parent/Guardian Full Name

Address

Parent/Guardian Number

Parent/Guardian Email

What are your goals for these sessions?

What does the athlete need to improve on the most?

Does the athlete have any medical conditions or injuries we should know about?

By checking this box, I acknowledge and agree that my child will participate in all physical activities included in the Viva By Design program. I confirm that my child has no medical conditions or limitations that would prevent them from safely engaging in these activities. I have read, understand, and agree to the above

By checking this box, I release and hold harmless Viva By Design, its coaches, and the facilities at Inspiration Station ELC from any liability for injuries or damages that may occur to my child during training sessions or while on the premises. I, as the parent/guardian, accept full responsibility for any injury or damage that may occur during participation. I have read, understand, and agree to the above

Photo and Video Release Authorization

By checking this box, I grant permission for my child to be photographed and/or recorded during Viva By Design sessions. I understand that these images and videos may be used for promotional purposes, including social media, website content, and other marketing materials.

By checking this box, I do not grant permission for my child to be photographed or recorded during Viva By Design sessions for use on social media, the website, or any promotional materials.