Member Details

* Required field
Add secondary Phone +


Emergency Contacts

Additional Contact


Edit Photo

Capture from camera No camera found. Please connect a camera to use this feature. Upload photo

Waiver / liability release

I hereby acknowledge and agree that in consideration of being allowed to participate in any way in the Nanaimo Boxing Club including but not restricted to training, field trips, sparring, boxing while particular rules, equipment and personal discipline may reduce this risk, the risk of serious injury does exist; and,

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others and assume full responsibility for my participation; and
I willingly agree to comply with the stated and customary terms and conditions for participation If I observe any unusual significant concern in my readiness for participation and/or in the program itself, I will remove myself from participation and bring to the attention of the nearest coach immediately; and
I for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin HEREBY RELEASE Nanaimo Boxing Club, their coaches, contractors, directors, officers, members, volunteers, and/or employees, other participants and lessors of premises used in conduct the events (releasees) WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY INCIDENT TO MY INVOLVEMENT OR PARTICIPATION IN THESE PROGRAMS, whether arising from negligence of releases or otherwise, TO THE FULLEST EXTENT OF THE LAW.
I, for myself and on behalf on my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above releases from any and all liabilities incident to my involvement or participation in these programs. EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent of the law.

I clearly understand the Nanaimo Boxing Club will not permit me to participate in any program or activities unless I sign this Waiver and Release of Liability.

I have carefully read this release fo liability and assumption off risk agreement, and understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. I understand that by signing this agreement I will forever be prevented from suing or otherwise claiming against the Nanaimo Boxing Club, its members, volunteers, officers, directors, employees and/or contractors for any loss or damage that I may sustain while participating in or preparing for any of the above mentioned boxing programs. I have been given the opportunity to seek independent legal advice prior to signing this agreement which requirement I hereby waive.

If I am signing on behalf of a minor child, I also give full permission for any person connected with Nanaimo Boxing Club to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child.



Done Clear Sign Below:

Participants involved in any activities offered by Nanaimo Boxing Club may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the Nanaimo Boxing Club website or in any editorial, promotional or advertising material produced and/or published by Nanaimo Boxing Club.

Done Clear Sign Below:

I all participants of Nanaimo Boxing Club agree to abide by the following points when entering cub facilities under the COVID-19 Response plan and RPT Protocol.

  • I agree to symptom screening checks, and will let my club know if I have experienced any of the symptoms in the last 14 days
  • I agree to stay home if feeling sick, and remain home for 14 days if experiencing COVID-19 symptoms.
  • I agree to sanitize my hands upon entering and exiting the gym, with soap or sanitizer 
  • I agree to sanitize the equipment I use throughout practice with approved cleaning products provided by the club 
  • I agree to follow social distancing protocols of staying at least 3 meters from others 
  • I agree to abide by all my club’s policies and guidelines
  • I understand that if I do not abide by the aforementioned policies/guidelines, that I may be asked to leave the club for up to 14 days to help protect myself and others around me
  • I acknowledge that continued abuse of the policies and/or guidelines may result in a temporary suspension of membership 
  • I acknowledge that there are risks associated with entering club facilities and/or participating in club activities, and that the measures taken by the club and participants, including those set out above and under the COVID-19 Response Plan and Return to Sport Protocols, will not entirely eliminate those risks. 
Done Clear Sign Below:

How did you hear about us?

Account Password

Please pick a password to log-in to your account later. You'll be able to track your training and update your personal details and billing information online.