Urban Athletics - NYC running programs

Thank you for your interest in Urban Athletics' Training Programs.
Please complete the following form to begin your registration. All participant information, including agreement with the waiver and policies, is required.

Participant's First Name

Participant's Last Name

Address

City

State

Zip Code

Daytime Phone

Email Address

Retype Email Address (for verification)

Employer/Group

You will be asked for payment information after the following confirmation page. If the credit card holder's name will be different from the participant's name (above), please type the cardholder's name here.

Cardholder's Full Name (as shown on card)

For athletes under 18, provide parent Guardian's name:

Guardian's First Name

Guardian's Last Name

All Athletes Emergency Contact Info:

Emergency Contact First Name

Emergency Contact Last Name

Phome Number

URBAN ATHLETICS PROGRAM WAIVER
I know that participating in any Urban Athletics event is a potentially hazardous activity. I agree not to enter and participate unless I am medically able and properly trained. I agree to abide by any decision of an event coach relative to my ability to safely complete the event. I am voluntarily entering and assume all risks associated with participating in the event, including, but not limited to, falls, contact with other participants, spectators or others, the effect of the weather, including heat and/or humidity, traffic and the conditions of the course, all such risks being known and appreciated by me. I grant to the Medical Director of this program and his designee access to my medical records and physicians, as well as other information, relating to medical care that may be administered to me as a result of my participation in this program. Having read this Waiver and knowing these facts, and in consideration of your acceptance of this application, I, for myself and anyone entitled to act on my behalf, waive and release Urban Athletics, it’s employees and representatives and successors, from present and future claims and liabilities of any kind, known or unknown, arising out of my participation in this event or related activities, even though such claim or liability may arise out of negligence or fault on the part of any of the foregoing persons or entities. I grant permission to the foregoing persons and entities to use or authorize others to use any photographs, motion pictures, recordings, or any other record of my participation in this event or related activities for any legitimate purpose without remuneration.

REFUND, TRANSFER, AND DEFERRAL POLICIES

Group Programs

Withdrawals must be made in advance of the class session in order to receive a refund. An administrative fee of $20 will be charged for all refunds in addition to a portion of the package fee.

Cancellations or deferrals due to injury will be granted with a Doctor's letter, less a $20 cancelation fee.

To request a refund, please submit your request to info@UrbanAthleticsNYC.com.

There will be no transfer between Tuesday and Thursday, or Monday Wednesday Speed and Form class sessions without prior approval. To request a transfer info@UrbanAthleticsNYC.com.

Payments must be made in advance of receiving any training plans, or attending any group sessions.

Checks should be made out to "RunUrban".

One on One Training Cancelation policy

A 24 hour appointment cancelation is required. Without 24 hours notice of cancellation, you will be charged the full value of the session.

By checking this box, I indicate agreement with the Urban Athletics Waiver and Policies (Required for participation)

By checking this box I indicate agreement with the Urban Athletics Waiver and Polices as the guardian of the
registered athlete under the age of 18.


		1291 Madison Avenue @ 92nd Street New York, NY 10128 Phone: 212/828-1906 CLICK HERE for store hours and directions.