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Enrollment Information
Activities
Birthday Parties
Camps
Excel Gymnastics Open Gyms
Sr. Open Gym (6 and older)
Child Waiver
About Us
Employment
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Enrollment Information
Activities
- - Birthday Parties
- - Camps
- - Excel Gymnastics Open Gyms
- - Sr. Open Gym (6 and older)
Child Waiver
About Us
Employment
Birthday Party Waiver
Home
Birthday Party Waiver
Birthday Party Waiver
Date of Birthday Party
(Required)
MM slash DD slash YYYY
Day and Time
(Required)
Sat.: 12:00 – 1:45 PM
Sat.: 1:30 – 3:15 PM
Sat.: 3:00 – 4:45 PM
Sat.: 4:30 – 6:15 PM
Sat.: 6:00 – 7:45 PM
Sun.: 11:00 – 12:45 PM
Sun.: 12:30 – 2:15 PM
Sun.: 2:00 – 3:45 PM
Sun.: 3:30 – 5:15 PM
Sun.: 5:00 – 6:45 PM
Birthday Child's Name
(Required)
First
Last
Parent / Guardian Name
(Required)
First
Last
Address
(Required)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Cell Phone
(Required)
Email
(Required)
Child's Name
(Required)
First
Last
Date of birth
(Required)
MM slash DD slash YYYY
Gender
(Required)
Male
Female
Child's Name
First
Last
Date of birth
MM slash DD slash YYYY
Gender
Male
Female
Child's Name
First
Last
Date of birth
MM slash DD slash YYYY
Gender
Male
Female
Name
First
Last
Date of birth
MM slash DD slash YYYY
Gender
Male
Female
Medical Concerns
Consent
(Required)
Acknowledgment and Assumption of Risk
Acknowledgment and Assumption of Risk: I have informed myself, understand, and am aware of the risks associated with participation in gymnastics, dance and fitness programs and activities (Activities), including the possibility of injury or death. I have informed myself and understand the nature of these Activities, my or my child’s experience and capabilities and believe that I and/or my child is qualified, in good health, and in proper physical condition to participate in such Activities. I understand and acknowledge that the risk of injury and death exists in spite of all reasonable precautions that may be taken. By signing this form for myself, and/or my child, I hereby knowingly and willingly assume all of the risks for myself (and my child), including the risk of injury and even death.
Waiver, Release, Discharge, Indemnity, Hold Harmless and Covenant Not to Sue: I do hereby waive, release and discharge, for myself (and my child) and for all heirs, executors and administrators, any and all rights and claims for damages for personal injury or death suffered by me (us) against the owner, operators, coaches, and other agents of ENERGYM, LLC., Excel Gymnastics, WSSC, LLC. (Releasees) arising from or related to my (child’s) participation in the Activities at ENERGYM, LLC., Excel Gymnastics, WSSC, LLC.; and I hereby, covenant not to sue and agree to indemnify and hold harmless all Releasees from any and all liabilities, claims, demands and causes of action for losses or damages arising from personal injuries or death that may be suffered now or in the future from my or my child’s participation in the Activities.
Video/Photo Release: Participants and/or their parents hereby permit the taking of photos, audio and video while using the facilities or programs at Excel Gymnastics for publications and use as Excel Gymnastics see fit.
Signature – Typed
First
Last
Date
MM slash DD slash YYYY
