Convergence Registration Form 2018
Celebrating Acrobatic movement.

Please mark yourself as "Going" on the Facebook Event Page:

>>>>>> Please fill out one form for PER participant. <<<<<<<<

Email address *
Today's date: *
Legal Names (First and Last) *
Your answer
The name(s) you use, if different than above.
Your answer
I am coming for: *
I have been doing Acro (of any sort) for *
I am based in (or in the surrounding area) *
There will be healthy & delicious food vendors on Saturday for dinner and on Sunday for lunch! Which of the following best matches your preferred diet?
PAYMENT: *** Please do not submit this form until you have actually sent payment to From CANADA: please send via eTransfer. From the USA, please send via PayPal and select "Friends and Family" *
I will help make Convergence even better next year by filling out the feedback form that will be e-mailed to me after the event!
AGREEMENT OF RELEASE AND WAIVER OF LIABILITY I hereby agree to the following: 1. I am participating in the Convergence Acro Festival by my own free will. During this event I may receive information and instruction about acrobatics, acroyoga, cheerleading, Thai massage and related activities. I recognize that acrobatics, yoga, cheerleading, Thai massage and related activities require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. 2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any or all offerings by Convergence Acro Festival, I represent, verify, and warrant that I am physically fit and that I have no medical condition that would prevent my full participation in this event. 3. In further consideration of being permitted to participate in any or all offerings by Convergence Acro Festival, I knowingly, voluntarily and expressly waive any claim I may have against Convergence Acro Festival, or any of their subsidiaries, including the venue Power Cheer Gym and its subsidiaries, for injury or damages that I may sustain as a result of participating in their offerings. 4. I further hereby indemnify and hold harmless Convergence Acro Festival and it’s organizer(s) and affiliates from any and all damages, liabilities, costs and expenses, including reasonable attorneys’ fees, arising out of or relating to any claim by a third party resulting from my practice or instruction in the field of acrobatics, yoga, cheerleading, Thai massage, or related activity. 5. I, my heirs or legal representatives forever release waive, discharge and covenant Convergence Acro Festival, and any of their subsidiaries for any injury or death caused by their negligence or other acts. I have read the above release and waiver of liability and fully understand its contents. *
Need accommodation? Convergence Acro Festival has scored some group discount rates at a downtown hotel and in residences at Fanshawe College. Information & Booking here:
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