REGISTRATION/RELEASE FORMS
download a printable copy here
Jump Rope Registration Form Here
S.P.O.R.T. Gymnastics Registration and Liability Release
1st Class Day & Time ___________________________
2nd Class Day & Time __________________________
Birthday Party ____ Play Gym ____ Camp _____ Open Gym _____ Field Trip _____
1st Student’s Name __________________________ M / F Birthdate ________/________/________
2nd Student’s Name __________________________ M / F Birthdate ________/________/________
3rd Student’s Name ___________________________M / F Birthdate ________/________/________
Home Phone ________________________ Email __________________________ Zip ____________
Address ________________________________________ City __________________ State _______
Mother’s Name ______________________________________Employer _______________________
Mother’s Cell ______________________________________ Mother’s Wk. # __________________
Father’s Name ______________________________________ Employer ______________________
Father’s Cell ______________________________________ Father’s Wk. # __________________
Emergency Contact _____________________________________ Ph. # ________________________
Please declare any physical problems or restrictions and list any mental/behavioral or special custody situations that would be important for us to be aware of. ____________________________________
__________________________________________________________________________________.
Please tell us how you heard about us.
Friend (name)_______________________ Webpage _____ Newspaper ______ Yellow Pages______
Radio _____ Other _____
Check here if you would like us to send you our email newsletter, promotions, new classes, and special events. ______ Email: _______________________________________________________
Please read this Liability Release Form Carefully and sign as indicated.
In consideration of allowing the previously declared participant(s) to begin activity at S.P.O.R.T., while on the premises and property of said gym, the undersigned, for themselves and/or being the legal and acting guardian of participant, acting for themselves and on behalf of the participant, release and hold harmless S.P.O.R.T. LLC, its owners, officers, employees, and agents of and from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the particpant and /or the undersigned, while in or upon the premises upon which S.P.O.R.T. is conducted, or any premises under the control and supervision of S.P.O.R.T., its owners, officers, employees, or agents or in route to or from any of said premises or while at any premise or place when activities sponsored by or participated in by S.P.O.R.T. LLC, its owners, officers, agents, or employees.
Assumption of Risk - Participation in physical activities can involve motion, rotation, and height in a unique environment and as such carries with it a certain assumption of risk. The undersigned and the participant (s) choose to voluntarily enter upon said premises under the control of said corporation, knowing their present condition and knowing that said condition may become more hazardous and dangerous during the time the participant or the undersigned is upon said premises. The undersigned and the participant (s) voluntarily assume any and all risks of loss, damage, or injury that may be sustained by the participant (s) and/or the undersigned or any property owner by them while on or upon said premises described above. The corporation may but shall not be obliged to carry insurance on the participant (s), and the existence of insurance shall not change, alter, or increase the liability of the corporation to the participant and the undersigned or affect the terms of the Release. In signing this Release, the undersigned acknowledges:
*a. That he/she has read thoroughly and understands completely, the terms of Registration and Release and signs it voluntarily.
*b. That the undersigned signing either for themselves, or as Legal Guardian is, in fact, the true and legal guardian and has the consent of the participant.
Medical Release
The undersigned gives permission for the S.P.O.R.T. LLC, owners, officers, employees, and/or agents to seek emergency medical treatment for the participant (s) in the event they are unable to reach any parent or guardian. The undersigned also agrees that they themselves will be responsible for any financial debt incurred by said action.
Marketing Release
I understand that my child's likeness may be used in S.P.O.R.T. Gym ads, promotional videos, website material, or various other marketing. These images will be used for S.P.O.R.T. purposes only and will not be given or sold to outside companies or individuals.
Payment Information
Tuition is due on the first of the month and is based on flat monthly payments. You will receive 3 - 5 classes per month and over a 9 month period will balance itself out. Classes go through the first week in June. During December, your student will also be given an Open Gym Pass. If you miss a class due to illness or family emergencies, please call and notify us in advance and we will schedule a make-up or give you an Open Gym or Play Gym Pass. If you decide to stop attending, we need a written 2 week notice or you will be billed for the next month.. Tuition is due on the first of the month and late after the 10th. There is a $5.00 fee for late payments. We do not bill. Please put payments in the payment box on the desk or send to: PO Box 3331, Wenatchee, WA 9007.
Parent/Guardian Signature_____________________________________________Date________________
Participant Signature if over 18 yrs. of age ____________________________ Date _______________
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