VH Fall Gymnastics 2021
Please get registered now for our Fall gymnastics class of 2021. This class will be operated by Moore Gymnastics and Pacha Gymnastics. They teach tumbling for ages Preschool to 6th grade. All experience levels are welcome from somersaults to back tucks.

This class will run for 10 Wednesdays, from September 8th to November 10th at the Waterville Community Center. This class requires a pre-registration as well as a $50 fee for Valley Heights students and $100 for non-Valley Heights students. The fee must be submitted no later than September 8th.

QUESTIONS PLEASE CONTACT
Tony Yungeberg: tyungeberg@valleyheights.org or 785-363-2211 or Courtney Moore: courtdmoore@gmail.com
YOU MUST FILL OUT A FORM FOR EACH CHILD YOU ARE ENROLLING
REGISTRATION IS DUE BY AUGUST 9TH

FAMILIES WILL BE NOTIFIED OF THEIR CLASS TIMES
Fees may be submitted to the Valley Heights Central office or your student's Valley Heights school
FEES MUST BE SUBMITTED BY SEPTEMBER 8TH
CLASS DATES ARE AS FOLLOWS:
SEPTEMBER 8, 15, 22, 29
OCTOBER 6, 13, 20, 27
NOVEMBER 3, 10
Student name (first & last) *
Birthdate *
Gender *
School child attends *
Current grade (2021-2022 school year) *
Are there any health concerns that you may have in regards to your student?
Parent/Guardian name(s) *
Phone number(s) *
Address (Street, city) *
Parent/Guardian email(s) *
Valley Heights Community Education, Moore Gymnastics, Pacha Gymnastics Wavier and Release Form
Liability Wavier and Indemnity Agreement: I, as a parent or guardian of a participant in activities offered by Moore Gymnastics, Pacha Gymnastics, and Valley Heights Community Education, am aware and understand the risks involved in the sport of gymnastics and acknowledge the possibility of injury, including but not limited to serious head or neck injury, paralysis, or even death. I agree to the following: I waive any claim for bodily injury, personal injury, or property damage against Moore Gymnastics, Pacha Gymnastics, and Valley Heights Community Education, its owners, representatives, and any equipment used in connection with any programs of Moore Gymnastics, Pacha Gymnastics, and Valley Heights Community Education, arising out of my child’s participation in any of the programs of Moore Gymnastics and Pacha Gymnastics. I understand that this waiver extends to injuries incurred by any member of my family, including my children identified above, myself, or any other family member. If this agreement is not effective to waive liability on behalf of my child, myself, or any other family member, we further agree to indemnify Moore Gymnastics, Pacha Gymnastics, and Valley Heights Community Education for its liability including all costs, fees, and expenses incurred in connection with such liability.
By entering my name below I acknowledge that I have read and understood Moore Gymnastics, Pacha Gymnastics, and Valley Heights Community Education Wavier and Release Form and agree to abide by them through the course of me and my family’s involvement with the program. *
PUBLICITY RELEASE FORM: I authorize Moore Gymnastics, Pacha Gymnastics, and Valley Heights Community Education or their representatives to record and photograph me or my child’s image and/or voice for use of educational and promotional programs. I also recognize that these audio, video and image recordings are the property of Moore Gymnastics and Pacha Gymnastics. *
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