CLASSIC GYMNASTICS REGISTRATION FORM
1. Student Name ____________________________________________
Birthday _______________ Age ____ Sex _____
2. Student Name ____________________________________________
Birthday_______________ Age____ Sex _____
Address _________________________________________
City _________________________ Zip______
Home Phone ____________________ Cell Phone ___________________
E-Mail _____________________________
Father Name ____________________________________
Mother Name_____________________________________
Father Work Phone _______________________________
Mother Work Phone ___________________________
Additional Emergency Name _________________________________
Phone ______________________________
Any special problems we need to be aware of _________________________________________________________
How did you hear about us? ______________________________________________
Class Selection
Preschool _____ Gymnastics _____ Tumbling _____ Day _______ Time ________
Payment Information
I understand tuition is due monthly and will be charged a late fee of $10.00 if payment is not
received by the 8th of each month. No billing statements will be mailed. A$25.00 returned check fee would apply to all returned checks.
Make up Policy
Call the office to schedule a make up.
Drop Policy
When withdrawing from the program it is necessary to inform us in writing 1 week prior to your withdrawal date. All accounts without proper withdrawal notice are automatically charged for the upcoming month. A withdrawal notice can be obtained at the front office.
Acknowledgment of Risk and Waiver of Liability
In consideration of participating in the sport of gymnastics I represent That I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue in the Activity.
I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the "releases" named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the Activity.
I hereby release, discharge, and covenant not to sue Classic Gymnastics LLC, its Respective administrators, directors, agents, officers, volunteers, and employees, other participants, and sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the "releasees" or otherwise, including negligent resue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, ability, damage, or cost, which any may incur as the result of such claim.
I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extend allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
___________________________ ___________________________ Date: ______________
Print name of participant Signature of participant
Parental Consent
And I, the minor's parent and/or legal guardian, understand the nature of the above referenced activities and the Minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby Release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees from all liability, claims, demands, losses or damages on the minor's account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasee may as the result of any such claim.
______________________________ ______________________________ Date: ______________
Print name of Parent/or Legal Guardian Signature of Parent/or Legal Guardian
Office Use
Reg: ___________ Cash: _________
Tuition: ___________ Check No: _________
