Enrollment Form & Waiver 1Child Enrollment Info2Parent Info3Athletic Participation Waiver Child #1*First NameLast NameAge Date of Birth*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child #2First NameLast NameAge Date of BirthMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone*Email* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date Enrolled*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child #1 Social Security NumberChild #2 Social Security Number Parent #1* First Last Phone*Parent #2 First Last PhoneRelative or Friend* First Last Phone*Requested Date* MM slash DD slash YYYY Requested Time* : Hours Minutes AM PM AM/PM Impairment, Emergency or Special Information?* Yes No Medical Conditions If Yes, Please DescribePrimary Insurance Carrier*How Did You Find Us?* 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 gymnasticsDROP 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. Δ Baldy View Updates Thanksgiving November 13, 2024 Planning a party? Need a hosting facility? April 4, 2014
