Jump Around Gymnastics Waiver
WAIVER, RELEASE, ACKNOWLEDGMENT OF RISK AND INDEMNIFICATION AGREEMENT
Sign in to Google to save your progress. Learn more
Email *
Child's Name: *
Child's Date of Birth *
MM
/
DD
/
YYYY
2nd Child's Name:
2nd Child's Date of Birth
MM
/
DD
/
YYYY
3rd Child's Name:
3rd Child's Date of Birth
MM
/
DD
/
YYYY
Pre-Existing medical conditions of which we should be aware:
Parent/Guardian's Name(s) *
Home, cell and/or work phone #'s: *
Emergency Contact Name: *
Emergency Contact Phone # *
WARNING: This agreement is legally binding. My signature indicates that I have read and understand this agreement and voluntarily agree to its terms. In consideration of my child's participation, we are waiving any claim or cause of action to recover compensation or obtain any other remedy for any present or future claims arising out of personal injury, property damage and bodily injury of any kind arising out of my child's use of Jump Around Gymnastics facilities and equipment and/or participation in classes, activities and events at Jump Around Gymnastics, whether supervised or unsupervised, whether on or off Jump Around Gymnastics premises or travel for the purposes of participating in any such program or event. I understand that this waiver extends to injuries incurred by any family member of our family. *
Required
I hereby release, protect, indemnify and hold harmless Jump Around Gymnastics, including owner, employees, volunteers, affiliates or other persons whom may be present at Jump Around Gymnastics from and against any and all losses, claims, causes of action, damages, costs, expenses and liability in connection with any injury, illness or death of any person or damage to any property (including all reasonable expense of litigation, court costs and attorney's fees) incurred in connection with my child arising out of the use of Jump Around Gymnastics and I hereby waive any right against Jump Around Gymnastics. *
Required
I understand that gymnastics, as a sport, has inherent risks. I hereby acknowledge and agree that the sport of gymnastics and the use of Jump Around Gymnastics facilities, equipment, classes, activities and/or events have inherent risks, including catastrophic injury, death, paralysis and the mats and other safety equipment and apparatus provided for my protection may still leave my child vulnerable to the reckless actions of others at Jump Around Gymnastics *
Required
I, the parent/guardian of the child named above, agree that he/she will abide by the rules of Jump Around Gymnastics. *
Required
I acknowledge that the child named herein is physically fit and mentally capable of performing the physical activity chosen. I hereby acknowledge my responsibility in communication any physical and psychological concerns that might conflict with my child's participation at Jump Around Gymnastics and have listed all pre-existing medical conditions above. *
Required
If I, or the emergency contact, cannot be reached, Jump Around Gymnastics may authorize medical care and treatment for my child. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent. I accept responsibility for all associated expenses. *
Required
I represent that I have legal capacity and authority to act on behalf of the child named herein. *
Required
Parent/Guardian Signature: *
Current Date: *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms