2020-2021 Fall-Spring Wild Cats Gymnastics Class
This class is for boys and girls Age 3-4.5. This class runs 45 minutes, once a week for 8 weeks beginning the week of September 14th, 2020. Tuition is $185 per session. Please complete the form and select your class choice. Please email crosspointgym@gmail.com or call 610-497-1777 for questions. Thank you!
Email address *
Student's Full Name *
Student's Age *
Parent Name *
Cell Phone # *
Home Phone #
Home Address *
Physician Name and Phone Number *
Student Allergies or Medical Conditions *
Class Selection *
Please choose the Day and Time of your class. If you do not see a scheduled class below, it is because the class is currently full.
TUITION Payment Agreement: Please Review our Tuition Payment Policy and after you Submit Registration, return to the website's ONLINE PAYMENTS Page to pay online. *
Required
WAIVER: I am aware that gymnastics and tumbling are vigorous sporting activities involving height and rotation in a unique environment and as such they pose a risk of injury. I understand that gymnastics and related activities always involve certain risks, including but not limited to death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage and serious injury to virtually all bones, joints, muscles and internal organs and that the mats, pits and other safety equipment and apparatus provided for my child’s protection, including the active participation of a coach or teacher who will spot or assist in the performance of certain skills may be inadequate to prevent serious injury. The risk of harm may be limited by all of the safety equipment and trained coaches, but never eliminated. I understand that participation in gymnastics and related activities involves activities incidental to active participation in gymnastics, including moving from event to event, conditioning, stretching, outdoor games and other activities which may leave my child vulnerable to the negligent and/or reckless actions of other participants who may not have complete control over their actions or knowledge of the risks involved and hereby agree to accept all inherent risks of property damage, personal injury or death that may occur as a result of participation in gymnastics and its related activities. *
Required
COVID-19 RELEASE OF LIABILITY: I understand the hazards of the novel coronavirus (“COVID-19”) and am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19. I acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that the CDC guidelines are regularly modified and updated and I accept full responsibility for familiarizing myself with the most recent updates. Notwithstanding the risks associated with COVID-19, which I readily acknowledge, I hereby willingly choose to have my child participate in gymnastics activities, meets, training, and/or camp, hereinafter “the Activities” at Roth’s CrossPoint Gymnastics. Inc. I acknowledge and fully assume the risk of illness or death related to COVID-19 arising from my child being at CrossPoint Gymnastics Center and participating in the Activities and hereby release and/or discharge and/or agree not to sue (on behalf of myself and any minor child for whom I have the capacity contract) Roth’s CrossPoint Gymnastics, Inc., their owners, officers, directors, agents, employees and assigns from any liability related to COVID-19 which might occur as a result of my or my child being on the premises and participating in the Activities. It is my express intent that this release shall bind any assigns and representatives, and shall be deemed as a release and/or discharge and/or agreement not to sue. *
Required
PARENTAL AGREEMENT TO TAKE TEMPERATURE: Roth’s CrossPoint Gymnastics, Inc. will daily take the temperature of its employees to ensure no employee has a temperature above 100.4 degrees Fahrenheit. I acknowledge and agree that I will take the temperature of my child each day before sending him or her to CrossPoint Gymnastics Center and if he or she has a temperature above 100.4 degrees Fahrenheit, I will not send them to CrossPoint Gymnastics Center. I further acknowledge and agree that if my child has a fever above 100.4 degrees Fahrenheit I will follow all recommended CDC guidance before sending him or her back to CrossPoint Gymnastics Center. *
Required
RELEASE OF LIABILITY: I understand that this waiver and Covid-19 release of liability is intended to be as broad and as inclusive as permitted by the laws of the Commonwealth of Pennsylvania and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be within the State of Pennsylvania. In consideration of my participation, I hereby release and covenant not to sue CrossPoint Gymnastics LLC. or any of their employees, teachers, or coaches from any all present and future claims resulting from ordinary negligence of CrossPoint Gymnastics or others listed for property damage, personal injury or wrongful death, arising as a result of my engaging in or receiving instruction in gymnastics, cheerleading, tumbling, camp activities, outdoor activities or any other activities incidental thereto, wherever, whenever or however the same may occur.I further agree to indemnify and hold harmless CrossPoint Gymnastics, Inc.. for any and all claims arising as a result of my engaging in or receiving instruction in CrossPoint Gymnastics Center, or any outdoor camp activities incidental thereto, whenever, wherever or however the same may occur. *
Required
MEDICAL AUTHORIZATION: In the case of an emergency, I authorize Roth’s CrossPoint Gymnastics, Inc. to transport my child and/or ward to a doctor, hospital or other health care facility and to act in my place to obtain medical or hospital treatment, if unable to reach a parent or guardian. *
Required
USE OF IMAGES/NAME IDENTIFICATION I authorize Roth’s CrossPoint Gymnastics, Inc. to use images of my child(ren) without name identification, for Roth’s CrossPoint Gymnastics, Inc.’s publicity, promotional and/or advertising purposes and I hereby release any and all claims and/or rights I and/or my child and/or ward might have as a result. *
Required
ACKNOWLEDGEMENT OF RULES AND POLICIES: I acknowledge that Roth’s Crosspoint Gymnastics, Inc. has rules and policies in place regarding safety, registration, tuition payment, use of facilities, and conduct. These rules include, but are not limited to: tuition payment must be paid in full for a student to participate. Class fees are non-transferable and non-refundable after the session begins. I have reviewed and understand the rules and policies currently in place. I understand that failure to follow the rules and/or policies may result in revocation of all entitlements and/or privileges without refund of prepaid fees, at Roth’s CrossPoint Gymnastics, Inc.’s‘ absolute discretion. *
Required
Please Sign by Typing your full name followed by your initials. *
A copy of your responses will be emailed to the address you provided.
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