Minor Waiver for The Wellness Clinic at Lifequest MINOR'S NAME: (first and last name) MINOR'S DATE OF BIRTH: MINOR'S ADDRESS: GUARDIAN'S NAME: (first and last name) GUARDIAN'S CONTACT NUMBER: GUARDIAN'S EMAIL: MINOR WAIVER ACKNOWLEDGEMENTI represent to LifeQuest Fitness Center that I am physically fit to perform those activities which I may undertake at the Club. I am solely responsible for all health risks associated with such activities. I acknowledge that my attendance at or use of the Club or participation in any of the Club’s activities or programs including without limitation to my use of the equipment and facilities, I hereby assume all risks of personal injury, death, property loss, or other damages which may result from or arise from the attendance at or use of the Club or participation in any of the Club’s activities and programs. The foregoing risks shall include, but are not limited to, risks associated with; aerobics, fitness equipment, weight lifting, team and individual sports, exercise, rock wall climbing, locker room, sun tanning, nursery, parking environment, theft, contagion, or any other losses such as personal injuries, property loss, or other damages connected to or arising out of an aforesaid risks.I hereby, on behalf of myself and my heirs, executors, administrators and assigns, fully and forever release and discharge LifeQuest Fitness Center from any and all claims, damages, demands, rights or action or causes of action, present or future, known and unknown, anticipated and unanticipated, resulting from and arising from my attendance at or use of the Club. Further, I hereby release and discharge the Club from any and all liability for any loss, theft or damage to personal property, including without limitation automobiles and the contents of lockers. BY CHECKING THIS BOX, I AGREE TO THE ABOVE STATEMENT FOR THIS MINOR WILL YOU BE USING THE KIDS CLUB SERVICES FOR THIS CHILD? YES NO KIDS CLUB POLICIES KIDS CLUB HOURS OF OPERATION MONDAY - SATURDAY 8:00am - 12:00pm MONDAY - THURSDAY 4:00pm - 8:00pm FRIDAY 4:00pm-7:00pm Children must be at least 8 weeks of age and no older than 12 years old. Reservations are not required but if the Kids Club reaches capacity you may have to wait to check your child in. You may reserve your child’s time by calling 509-545-5191 or visiting your online account. No food or drink is allowed in the Kids Club. Water bottles are the exception. Sick children are not permitted in Kids Club. Please keep your child home if they are experiencing any of the following issues: Fever, irritability, lethargy, persistent crying, or difficulty breathing Upper respiratory illness such as bronchiolitis or influenza Diarrhea Vomiting within the last 24 hours A rash Chicken pox Impetigo Scabies Bacterial conjunctivitis (pink eye) and/or yellow discharge from the eye Streptococcus (strep throat) Mouth sores that cause excessive drooling and are contagious Head lice Runny nose with colored mucus Confirmed Covid-19 or Covid-19 symptoms Parents and guardians must remain inside of the building while their child is attending Kids Club. No outside toys and/or electronics are allowed. Lost or stolen items are not the responsibility of The Wellness Clinic at LifeQuest Parents must provide their own bottles and diapers. Kids Club staff does not change diapers. Parents will be notified by call or in person when their child is in need of a diaper change. Diapers are not allowed in the facility’s trash can. Please take all soiled diapers with you. Staff will alert parents when their child needs to use the restroom if the child requires assistance. Staff does not assist children in the bathroom. Socks are required for every child. When children check into Kids Club they are asked to remove their shoes. Removing shoes helps with the excessive germs. Staff cannot administer medications. For your child’s security, we ask that each child is checked into the Kids Club. The Kids Club staff will take a photo of your child for their profile. This profile is for internal use only. Only parents and approved guardians (written request required) can pick up a child. Photo ID is required on each parents and approved guardian’s account. If special arrangements need to be made, The Wellness Clinic at LifeQuest requires a written request. This request can be emailed to client@lifequestfitness.net or be presented to the Service Desk manager. KIDS CLUB CHECK IN PROCEDURE Scan your child’s key tag. Remove shoes and place them in the basket. Put on socks if they are not wearing them. Socks are required and can be purchased for $1.00. Hang up any coats and bags. There are lockers located outside of the Kids Club if you would like to use a locker. Inform the staff of any special instructions regarding your child and where you will be in the facility in the event of an emergency. KIDS CLUB CHECK OUT PROCEDURE Only a parent or guardian listed on the wellness plan can pick up your child unless special written permission has been given. Collect your child and his/her’s belongings BY CHECKING THIS BOX, I ACKNOWLEDGE I HAVE READ THE ABOVE STATEMENT & AGREE TO UPHOLD THE POLICY CHILD APPROVED ACTIVITIES AND SPACES Age 0-8 years: Kids Club Age 8-11 years: Kids Club, game room, courts and fields when available. The climbing wall is open for children over the age of 6 as long as they can safely fit in a climbing harness. The climbing wall is open MONDAY - THURSDAY 6:00pm - 8:00pm This activity is a first come, first served basis. Age 12-13 years: Supervised workouts on the main floor, women’s zone and group fitness classes. Also, the climbing wall, courts and fields when available. Please note that not all children ages 12-13 may be ready for this responsibility. If staff sees unsafe practices, you as the parent or guardian will be notified. Age 14+ years: Unsupervised workouts on the main floor, women’s zone and group fitness classes when you as the parent deems the child knowledgeable and mature for this action. Also, the climbing wall, courts and fields when available. The child is expected to follow all clinic’s policies just as adult clients are required. It is strongly recommended your 14+ aged child attend a complimentary personal training consultation for further instruction and safe use of all equipment. Please note that not all children ages 14+ may be ready for the responsibility of self monitoring. If staff sees unsafe practices you as the parent or guardian will be notified. BY CHECKING THIS BOX, I ACKNOWLEDGE I HAVE READ THE ABOVE STATEMENT & AGREE TO UPHOLD THE POLICY CHILD APPROVED ACTIVITIES AND SPACES Age 0-8 years: Kids Club Age 8-11 years: Kids Club, game room, courts and fields when available. The climbing wall is open for children over the age of 6 as long as they can safely fit in a climbing harness. The climbing wall is open MONDAY - THURSDAY 6:00pm - 8:00pm This activity is a first come, first served basis. Age 12-13 years: Supervised workouts on the main floor, women’s zone and group fitness classes. Also, the climbing wall, courts and fields when available. Please note that not all children ages 12-13 may be ready for this responsibility. If staff sees unsafe practices, you as the parent or guardian will be notified. Age 14+ years: Unsupervised workouts on the main floor, women’s zone and group fitness classes when you as the parent deems the child knowledgeable and mature for this action. Also, the climbing wall, courts and fields when available. The child is expected to follow all clinic’s policies just as adult clients are required. It is strongly recommended your 14+ aged child attend a complimentary personal training consultation for further instruction and safe use of all equipment. Please note that not all children ages 14+ may be ready for the responsibility of self monitoring. If staff sees unsafe practices you as the parent or guardian will be notified. BY CHECKING THIS BOX, I ACKNOWLEDGE I HAVE READ THE ABOVE STATEMENT & AGREE TO UPHOLD THE POLICY Signature Date Send
