Participation Waiver and Release

Please read carefully, complete every section, and sign below before the first session.

What this program is

BecomingHER is a mentorship program for teen girls that mixes mindset training with fitness, in an environment built for girls to feel mentally, physically, and emotionally confident and safe. The first session is one-on-one; later sessions may be one-on-one or in a small group of girls in the program. Sessions run one per week, about one hour, focused on confidence, mindset, and leadership. Sessions may include conversation, reflection exercises, creative activities, and fitness work such as walking, stretching, mobility work, bodyweight exercises, and supervised use of weights and medicine balls. This is mindset and fitness training, not athletic conditioning.

What this program is not: it is not medical care, mental-health therapy, nutritional counseling, or athletic conditioning. The mentor is not a medical provider and does not diagnose, treat, or advise on medical conditions, food, or eating.

1. Voluntary participation and assumption of risk

I understand that participation is voluntary and that all physical activity carries some risk of injury, including supervised activity with exercise equipment such as free weights and medicine balls. I voluntarily assume those risks on behalf of the participant named below.

2. Health disclosure and doctor clearance

I confirm that, to my knowledge, the participant is medically cleared for light physical activity such as walking, stretching, mobility work, bodyweight exercises, and supervised light strength work with weights or medicine balls.
I agree to disclose any medical conditions, activity restrictions, allergies, or medications on the intake form before the first session, and to update the mentor promptly if anything changes.
I understand that all movement in sessions stays within whatever the participant's doctor has cleared, and that the mentor will not push the participant beyond that.

3. Release of liability

To the fullest extent permitted by law, I release and hold harmless Legacy Lab Academy, Inc. and Dribble Drive Basketball Group (DD365), their owners, coaches, mentors, staff, and volunteers, the owners and operators of any property or facility where sessions take place, and anyone otherwise affiliated with the program, from any claims arising out of the participant's involvement in the program, except in cases of gross negligence or willful misconduct.

4. Emergency authorization

In the event of an emergency where I cannot be reached, I authorize the mentor to seek appropriate emergency medical care for the participant, and I accept responsibility for any costs incurred.

5. Payment

The free introductory session carries no charge. The mentorship is billed at $240 per month, payable through Step Up for Students or by self-pay. Step Up families are invoiced so they can reserve funds in the Step Up system. Billing runs month to month and may be cancelled with 7 days' notice before the next billing cycle.

6. Media (optional)

I give permission for Legacy Lab Academy, Inc. to use photos or short video clips of the participant from sessions in marketing (social media, website). I understand I can withdraw this permission in writing at any time. Leave unchecked to decline; sessions are identical either way.

Signatures

Participant name (teen)

Parent / guardian printed name

Date

Parent / guardian signature (type your full name)

Phone (for session-day contact)

Parent email (a copy of this form will be emailed to you)

I have read this waiver and agree to its terms. Typing my name above is my electronic signature. *

Questions before signing? Contact admin@legacylabinc.org. Keep a copy of this signed waiver for your records.