Return to Activity Form
To be completed by a parent or guardian
Email address *
Parent's Name *
Gymnast's Name *
Gymnast may return to partial practice on:
MM
/
DD
/
YYYY
Which activities are allowed by the doctor or therapist?
Gymnast is released for full participation on: *
MM
/
DD
/
YYYY
Please submit written release by attaching here, via mail or bring in to Altius.
Parent release without medical input:
Submit
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