Customization options — Golf with Ximu at La Cañada Elementary School
Summary
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Child's Full Name
(required)
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Child's Grade
(required)
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K
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1st
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2nd
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3rd
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4th
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…and 2 more
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Golf Experience
(required)
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Beginner
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Intermediate
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Advanced
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Are you registering more than one child?
(required)
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Additional Child Information (Full Name, Grade)
(optional)
(Child 2: Jordan Smith, 2nd grade
Child 3: Taylor Smith, 4th grade)
— This option may appear depending on other selections.
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Parent Full Name
(required)
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Parent Email
(required)
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Parent Phone Number
(required)
Ximu LLC Participation Waiver and Assumption of Risk I certify that I am the parent or legal guardian of the child being registered and have the legal authority to enter into this agreement on the child’s behalf. I voluntarily authorize my child to participate in athletic instruction, recreational activities, exercises, games, and related programming provided by Ximu LLC. Program activities may include golf, baseball, football, running, swinging or using sports equipment, physical movement, coordination exercises, and other age-appropriate athletic activities. I understand that participation in sports and physical activities involves inherent and other risks that cannot be completely eliminated. These risks may include being struck by sports equipment or a ball, contact with another participant or instructor, slips, trips, falls, collisions, muscle strains, sprains, bruising, overexertion, equipment-related injuries, environmental conditions, and other injuries associated with physical activity. I understand that Ximu LLC takes reasonable safety precautions, including instructor supervision, age-appropriate equipment, designated activity areas, and established safety rules. However, I understand that no athletic or recreational activity can be made completely free from risk. I confirm that my child is physically capable of participating, except for any medical conditions, allergies, injuries, physical limitations, behavioral considerations, or necessary accommodations that I have disclosed during registration. I agree to notify Ximu LLC if this information changes. I agree that my child must follow all safety instructions, remain within designated activity areas, use equipment only when instructed, and behave in a manner that does not endanger themselves or others. I understand that Ximu LLC may restrict or discontinue my child’s participation when reasonably necessary for safety. Knowing and understanding these risks, I voluntarily allow my child to participate and assume the inherent and other risks associated with participation. To the fullest extent permitted by California law, I, individually and on behalf of my child, release and discharge Ximu LLC and its owners, officers, employees, instructors, independent contractors, assistants, agents, representatives, and authorized volunteers from claims arising from my child’s participation, including claims for bodily injury, illness, death, medical expenses, or property damage resulting from the ordinary negligence of the released parties. This release does not apply to gross negligence, reckless or willful misconduct, fraud, intentional wrongdoing, or any claims or rights that cannot legally be waived. If my child becomes injured or ill during a Ximu LLC program, I authorize Ximu LLC personnel to provide reasonable first aid and contact emergency medical services when reasonably necessary. If I or the designated emergency contact cannot be reached promptly, I authorize emergency medical personnel to evaluate and treat my child as reasonably necessary. I accept responsibility for medical treatment, emergency transportation, and related expenses incurred on behalf of my child, except to the extent responsibility is legally assigned to another person or entity. By checking the acknowledgment box and entering my full legal name, I confirm that I have read and understand this waiver, voluntarily agree to its terms, and intend for my typed name and electronic acknowledgment to serve as my electronic signature. Waiver Version: August 3, 2026
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Participation Waiver Acknowledgment
(required)
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I certify that I am the participant’s parent or legal guardian. I have read and agree to the Ximu LLC Participation Waiver, including its assumption of risk, release of liability, and emergency medical authorization.
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Parent or Legal Guardian Electronic Signature
(required)
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Relationship to Participant
(optional)
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Parent
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Legal Guardian
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Other Authorized Guardian
