Name & Surname *

First Name

Last Name

Mobile Number *

(###)

###

####

Primary Discipline *

MTB

Road

Do you have a Heart Rate Monitor / Power Meter / Cadence Sensor *

Heart Rate Monitor

Power Meter

Cadence Sensor

None of the above

WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNIFICATION *

The ATHLETE hereby acknowledges that COBUS SNYMAN makes no warranties of any kind, express or implied, and does not guarantee individual results. The minimum services as a chosen package are guaranteed. The ATHLETE and not COBUS SNYMAN is personally responsible for achieving individual performance goals using the guidance and tools given by COBUS SNYMAN. The ATHLETE understands and accepts that they assume the risk of participating in the services, training, activities and races recommended by COBUS SNYMAN that may be inherently dangerous and carry the potential for death, serious injury and property loss. The ATHLETE confirms that they have not been advised against participation by a qualified health care professional. In consideration of this agreement, ATHLETE indemnifies, releases and forever discharges COBUS SNYMAN and any of his employees from any liability, claim, loss, cost or expense, and waives the right to bring legal action against COBUS SNYMAN or any of his employees arising directly or indirectly from ATHLETE's participation in the services, including claims or damages resulting from death, personal injury, partial or permanent disability or property damage, medical or economic loss. A one-month notice period will apply to terminate training plan services. COBUS SNYMAN maintains a strong anti-doping policy. If the ATHLETE is suspected or confirmed to be in violation of any of the World Anti-Doping Games and/or South Africa's Drug Free Sport regulations, the ATHLETE's training/coaching plans will be suspended with immediate effect. This waiver shall be binding on the heirs, assigns, successors and personal representatives of the ATHLETE. The ATHLETE further declares that they do not currently suffer from any physical or mental condition that would impair their ability to participate fully in the training provided by COBUS SNYMAN. The ATHLETE represents and warrants that they are twenty-one (21) years of age or older. If the ATHLETE is not twenty-one (21) years of age or older, at least one parent/guardian must fill out his/her name below, in order to have accepted the terms and conditions set forth between the ATHLETE and COBUS SNYMAN.

I ACCEPT THE WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNIFICATION