Welcome to the Phenom Gymnastics Program!
We are currently taking registration for Term 3 of our Recreational Gymnastics Program.
Term 3 begins January 4th, but new students may join in at any time.
Below is the registration form:
YOU MUST BE REGISTERED (turned in payment, the registration form, & waiver (below) before attending class.
Some classes may fill more quickly than others, so be sure to register early to ensure you get the class you’d like!
If you are new to the program, there will be an additional registration form to fill out, which you may pick up at the gym or have mailed to you.
GYMNAST NAME______________________________Age___________
1st Class choice (Day & Time)________________________________________
2nd Class choice if first choice is not available
(Day & Time)________________________________________
Amount due:_________________________
Upon payment & this registration form, you will be officially registered in the class of your 1st choice, unless we notify that it was not available.
To confirm class availability, give us a call--375-0055
Phenom Gymnastics, Inc.
TRY OUT REGISTRATION AND LIABILITY WAIVER
_______________________________________________________________
Student’s Last Name First
Age______ Birthdate_________ Phone ____________________________
Address______________________________________________________
City_____________ Zip _______ E-mail_____________________________
Father’s Name_______________________Work phone ________________________
Father’s Occupation____________________ Cell phone _______________________
Mother’s Name______________________Work phone ________________________
Mother’s Occupation____________________Cell phone ______________________
Person to Contact in emergency if you cannot be located:
Name___________________________Phone_________________________
Relationship______________________
How did you hear about us?______________________________________________
ACKNOWLEDGEMENT OF RISK, WAIVER OF LIABILITY, MEDICAL AUTHORIZATION, AND PHOTO RELEASE
As the legal guardian of __________________________________, I recognize that severe injuries, including but not limited to, permanent paralysis or death can occur in sports or activities involving height or motion, including but not limited to gymnastics, tumbling, dancing, exercise programs, trampoline, and cheerleading. Being fully aware of these dangers, I voluntarily consent to the aforementioned person to participate in any and all Phenom Gymnastics, Inc. programs and activities and I ACCEPT ALL RISKS associated with this participation.
In consideration for allowing my child to use these facilities and participate in these programs, I, on my own behalf, and of my child and our respective heirs, administrators, executors and successors, hereby forever PROMISE NOT TO SUE and FOREVER RELEASE Phenom Gymnastics, Inc., its officers, directors, shareholders, employees, contractors, volunteers, and all others associated with the corporation from all liability for any all damages and injuries suffered by my child while under the instruction, supervision, or control of Phenom Gymnastics, Inc.
I am aware that individual and group publicity photos and videos are taken from time and time and in consideration for my or my child’s participation I hereby grant my permission for my child’s likeness to be used in Phenom Gymnastics, Inc. publicity or advertising.
In the event of an accident or emergency I hereby authorize my above mentioned child to be transported to a hospital for medical treatment and I hold Phenom Gymnastics and its representatives harmless in the execution of such. Additionally, I hereby agree to individually provide for all medical expenses which may be incurred by me or my child as a result of any injury sustained while participating at or for Phenom Gymnastics.
I have read and understand this ACKNOWLEDGEMENT OF RISK and WAIVER OF LIABILITY and PHOTO RELEASE and MEDICAL AUTHORIZATION and I VOLUNTARILY affix my name in agreement.
PARENT/LEGAL GUARDIAN Signature___________________________________________________Date_______________