Activity Waiver

Sign Our Activity Waiver Before Starting a Gymnastics Class

Date of Activity*
Date Format: MM slash DD slash YYYY
Activity*
- Open Gym
- Birthday Party
- Field Trip
If attending a Birthday Party or Field Trip, Insert Time Here*

: HH

MM
If attending a Birthday Party, Insert Birthday Child's Name Here*
If attending the Bring a Friend activity, Insert Friends Name*
Child's Name*
First Last
Parent's Email*
Sex*
- Male
- Female
Child's Age*
Child's Birth Date*
Date Format: MM slash DD slash YYYY
Parents Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Home Phone*
Cell/Emergency Phone*
Medical, Physical or Other Concerns:*
ALL CHILDREN MUST HAVE THE RELEASE FORM SIGNED BY THEIR PARENT TO PARTICIPATE.

To the extent permissible by law, I/we hereby release, discharge and/or otherwise hold harmless and indemnify GymStars, LLC, it’s owners, officers, directors, employees and associated personnel, from and against any and all demands, claims and causes of action arising, directly or indirectly, from my child’s/ward’s participation in its programs.
THIS RELEASE SPECIFICALLY INCLUDES ANY DEMANDS, CLIAMS AND CAUSES OF ACTION ARISING OUT OF THE PAST OR FUTURE NEGLIGIENT ACTS AND/OR OMISSIONS OF GYMSTARS, LLC, ITS OWNERS, OFFICERS, DIRECTORS, EMPLOYEES AND ASSOCIATED PERSONNEL. PHOTOGRAPH AND STATEMENTS:

I AUTHORIZE USE OF MY CHILD'S VISUAL IMAGE AND STATEMENT IN SOCIAL MEDIA, NEWSLETTERS, POSTERS AND OTHER ADVERTISING.
Signature*
Date*
Date Format: MM slash DD slash YYYY