FAC Party Guest Waiver

Party Host Name(Required)

Event Date(Required)

Time of Event(Required)

Name of Junior Guest Attending(Required)

First Last

Age of Junior Guest(Required)

Name of Parent/Guardian(Required)

First Last

Parent/Guardian's Phone Number(Required)

Parent/Guardian's Email Address(Required)

Emergency Contact(Required)

First Last

Relation to Participant(Required)

Emergency Contact's Phone Number(Required)

I am responsible for the guest listed above. The guests listed above may use, at their own risk, any and all equipment, applicances, facilities and/or services owned and operated by Stegen Athletic Clubs, LLC d/b/a the Fayetteville Athletic Club. I will hold FAC, directors, operators, employees, representatives, and agents harmless from any, and all losses, claims, injury, damage, or liability sustained or incurred by me or my family resulting from participation in the party/event attending.(Required)