SNG Release & Registration Form
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT
In consideration of participating in the Special Needs Gymnastics (SNG) programs:
     I PERMIT the named athlete/student to participate in the programs offered by Denise Anderson and the other Associates of SNG. Participation in the activities offered by Denise Anderson, SNG, and the other Associates involve motion, rotation, and height, in a unique environment and as such carry with it a reasonable assumption of risk.
     I HEREBY EXPRESS THE INTENTION TO COMPLETELY RELEASE AND HOLD HARMLESS Denise Anderson and the other Associates from any and all claims, actions, demands, or those that may arise out of or be associated by directly or indirectly any negligent act(s) or omission(s) of Denise Anderson and the other Associates.
     I HEREBY VOLUNTARILY AND KNOWINGLY RELEASE any and all claims, actions, demands, or rights to any monetary judgements or be occasioned by, directly or indirectly, any negligent act(s) or omission(s) of Denise Anderson and the other Associates during the athlete's/student's attendance at and participation in any activities associated with Denise Anderson and the other Associates on any and all premises.
     I AUTHORIZE any representative of Denise Anderson, SNG, and the other Associates to take the necessary steps regarding medical attention (first aid, emergency transportation to the hospital, etc.) and will allow authorized hospital staff to treat me or my child or legal ward for any illness or injury I/he/she may have.
     I HEREBY GIVE CONSENT AND AUTHORIZATION to SNG and its agents and employees to reproduce photographs and/or videos of my child (me) for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium, without any compensation. Furthermore, I grant SNG the permission to communicate via email, phone, or text message any schedule changes, closures, monthly updates, or promotions related to any programs provided by SNG.
     I FULLY UNDERSTAND THAT I WILL BE RESPONSIBLE for the reasonable cost of repairing or replacing (to the extent that SNG determines, in its reasonable judgment that repairs cannot be adequately effected) any equipment damaged, damaged by graffiti, or destroyed by my child (me) or guests, beyond ordinary and reasonable wear and tear.
     I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY,  ASSUMPTION OF RISK, CONSENT, AND INDEMNITY AGREEMENT, and understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full legal force and effect.    
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Email *
PLEASE BRING A SPORTS WATTER BOTTLE TO CONSUME DURING THEIR TIME IN CLASS.
Athlete's/Student's First & Last Name: Please use 1 form for multiple children *
Select Program(s) *
Required
Pricing & Tuition Payment Options *
Notes to us:
Form of Monthly Payment - Due on the 1st of each month for that month's tuition. *
Membership *
I hereby give consent for the above named child/children to participate in programs and/or other physical activities under the direction of SNG. Parent/Guardian Initials:                                                                                    
Athlete's/Student's Age
Athlete's/Student's Date of Birth
Parent First & Last Name
Phone
Address - City - Zip Code
How did you hear about SNG?
Emergency Contact & Phone Number
Allergies/Health Conditions
Non-refundable full or prorated tuition payment and annual registration fee (if applicable) is due within 24 Hours of registration to reserve spot and is transferable to other classes or programs.
Credit Card - Payment can be securely submitted below and processed within 24 hours of registration, or given to Denise in person or over the phone within 24 hours of registration. A 5% charge will be added to credit card payments.
Cash/Check - Payment can be given to Denise within 24 hours of registration.
Credit/Debit Card Authorization
As a primary method of payment, I authorize SNG to charge the following credit card on the 1st of each month for that month’s tuition as subscribed in my enrollment. As a secondary payment method, if tuition is not paid by any other method on/or before the 5th day of each month for the that month's tuition, I authorize SNG to charge the following credit card for that month’s tuition  I understand we can unenroll in our class by the 10th of any month and my card will not be charged for the following month’s tuition. If unenrollment occurs after the 10th of the month, then the following month’s full tuition is subject to be charged to the card and is non-refundable, but transferable to other classes/programs. If my card fails to authorize for a payment by the 5th of the month, I will be liable for a $75 late fee.
Cardholder's First & Last Name *
Card Number *
Expiration Date *
Security Code *
Billing CITY & Zip Code *
I agree to all terms and conditions in this agreement with SNG. First & last name required. *
Today's Date *
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PLEASE BRING PLENTY OF WATER OR OTHER LIQUIDS FOR YOUR CHILD TO CONSUME DURING THEIR TIME IN CLASS.
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