Enrollment Form & Waiver

1 Child Enrollment Info

2 Parent Info

3 Athletic Participation Waiver

Child #1*
First Name Last Name Age
Date of Birth*
Child #2
First Name Last Name Age
Date of Birth
Phone*
Email*
Address*
Street Address City State ZIP Code
Date Enrolled*
Child #1 Social Security Number
Child #2 Social Security Number

Parent #1*
First Last
Phone*
Parent #2
First Last
Phone
Relative or Friend*
First Last
Phone*
Requested Date*
Requested Time*

: HH

MM
Impairment, Emergency or Special Information?*
- Yes
- No
Medical Conditions
If Yes, Please Describe
Primary Insurance Carrier*
How Did You Find Us?*
Signature*

I am aware that participation in this sport may be a potentially dangerous activity involving many risks of injury. I understand that the dangers and risks of participation include, but are not limited to, injury to: ligaments, muscles, tendons and other aspects of my body which may include neck or spinal injury.
Because of the dangers of the sport, I understand the importance of following the coaches’ instructions regarding techniques, training and other rules and agree to obey instructions.
In consideration for allowing me to participate, I hereby assume all the risks associated with the sport of gymnastics and agree to hold the gym, it’s employees or agents harmless from any and all liability which may arise in connection with my participation in gymnastics
DROP OFF/PICK UP PROCEDURES Children can arrive 15 minutes prior to their class, any earlier will result in a $10.00 fee per each 15 minutes/Per Child. You must not be any later than 15 minutes after their class for pick up, or you will have a fee of $10.00 per every 15 minutes/Per Child,that your child is under the care of the gym.
I, as the parent/legal guardian, have read the above warning and release and understand it’s terms. I understand the sport of gymnastics involves many risks, including but not limited to those outlined above. In consideration for the gym permitting my child to participate in gymnastics, I hereby agree to hold the gym, it’s employees and agents harmless from any liability which may arise in connection with participation of my child in gymnastics. The terms serve as a release.
Parent Signature*
Gymnast Signature*

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