Selected portal · adult

Adult Membership Setup

Complete client information, waiver, and dues agreement in one step.

Boxing ProgramWhich boxing program are you interested in? *

Client Information

First name *Last name *

Street address 1 *

Street address 2

City *State *ZIP code *Phone number *Email address *Date of birth *Emergency contact name *Emergency contact phone *

Portal Login

This password creates your secure portal login now. After approval, use it with the participant email entered above.

Create portal password *Confirm portal password *

Liability Waiver

NORTH CAROLINA BOXING TRAINING LIABILITY WAIVER AND ASSUMPTION OF RISK

Participant Identification

This agreement applies to the participant named above, residing at NC.

Acknowledgment of Inherent Risks

I understand that boxing, fitness training, sparring, bag work, mitt work, strength and conditioning, and other gym activities involve inherent risks, including serious bodily injury.

Express Assumption of Risk

I knowingly and voluntarily accept and assume the known and unknown risks associated with participation.

Release for Ordinary Negligence

To the fullest extent permitted by law, I release and waive claims against Mad House Boxing, its owners, coaches, staff, and agents arising from ordinary negligence connected with participation. This does not release conduct that cannot legally be waived.

Safety Instructions

I agree to follow all coach instructions, gym rules, equipment requirements, and safety directions, and to stop activity when directed.

Emergency Medical Consent

If I cannot provide consent during an emergency, I authorize reasonable emergency medical care and understand I am responsible for resulting costs.

I acknowledge that this electronic waiver will be treated as my signed agreement.

Optional: I consent to Mad House Boxing using photos or videos of participation for gym promotional purposes.

Waiver Record Preview

Ready to Sign

Participant: Not entered
Portal type: adult
Full address: NC
Date signed: 2026-09-02

Electronic SignatureType your full legal name as your electronic signature *Signed date

Dues

Adult Boxing Membership

$120 / month household total

Dues are due on the first of each month. This step records your dues agreement; it does not charge a payment method.

Payment method *Pay in CashPaid through World’sPay through StripeStripe is not connected yet.

I acknowledge the $120 monthly dues per child and understand they are due on the first of each month.