Mid-Columbia Gymnastics/Elite Force Cheer Special Activities Release Form
All children must have a release form signed by their parent or legal guardian to participate in any drop off activity (ex: open gym, birthday party if parent is not there to sign them in, etc)
Child's Full Name
Your answer
Age
Your answer
Birthdate
MM
/
DD
/
YYYY
(If you have only 1 child skip to Has your family ever attended MCGA before) #2 Child's Full Name
Your answer
Age
Your answer
Birthdate
MM
/
DD
/
YYYY
#3 Child's Full Name
Your answer
Age
Your answer
Birthdate
MM
/
DD
/
YYYY
Has your family ever attended MCGA before?
If not, how did you hear about us?
Your answer
If this release is for a birthday party attendee, date and time of party?
MM
/
DD
/
YYYY
Time
:
Parent's Full Name
Your answer
Parent's Email
Your answer
Address
Your answer
City
Your answer
State/Zip
Your answer
Best Phone # to reach you during activity
Your answer
Emergency Contact Name & Phone # (other than parent filling out form)
Your answer
Medical, physical, or other health concerns
Your answer
I understand and acknowledge that I possess full knowledge of the risk(s) of physical injury that are associated with such activities that are present at Mid-Columbia Gymnastics Academy Inc. This can include bodily injury that is catastrophic in nature. I do not hold MCGA its owners, staff or other visitors responsible for any injury to my child, myself, or any damage to my property. I authorize use of my child’s visual image and statements in social media, newsletters, and other advertising. By electronic signature, I confirm I am the parent or legal guardian of the above registrant(s)
Your answer
Date
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms