Registration

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Open Gym 12pm - 1:30pm - Age 4 (potty trained) - 17 - Please bring a water bottle for your child.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:*	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info*

Students entered below will be added to your family's account

Add New Student #1:

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Additional Information:

Assumption of Risk

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My child is voluntarily participating in a gymnastic sleepover which shall incorporate physical activity held
by Kansas City Gymnastics School, Inc. (collectively referred to herein as the “Activities”). I recognize
that the Activities require physical exertion that may be strenuous at times and may cause physical
injury to my child and I am fully aware of the risks and hazards involved.
I understand that it is my responsibility to consult with a physician prior to and regarding my child’s
participation in the Activities. I represent and warrant that my child has no medical condition that
would prevent his/her participation in the Activities.
I agree to assume full responsibility for any risks, injuries or damage known or unknown which my
child may incur as a result of participating in the Activities. Such injuries may include, but are not
limited to, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration,
injuries to knees, injuries to back, injuries to foot, or any other illness or soreness, including death.
I understand and agree that participation by my child in the Activities is voluntary and at his/her own
risk.
I understand and acknowledge that KC Gymnastics is not an insurer of my child’s, or any other child’s,
behavior, actions, attendance or participation in the Activities, and that KC Gymnastics assumes no
liability whatsoever for personal injuries, illness, death or property damages sustained by my child,
arising out of my child’s attendance at, or participation in, the Activities. I hereby agrees to release,
waive, covenant not to sue, indemnify (reimburse) and forever hold harmless KC Gymnastics, and all
of its officers, employees, independent contractors and agents (collectively the "Releasees") from any
and all known or unknown liability, claims, demands, actions and causes of action whatsoever arising
out of or in any way related to any loss, damage, or injury, including death, that may be sustained by
my child, or loss or damage to any property belonging to my child, arising out of or in any way related
to my child’s attendance at, or participation in, the Activities.
I have adequate health insurance to cover the costs of treatment in the event of any injury.
I HAVE CAREFULLY READ THESE TERMS AND FULLY UNDERSTANDS THEIR CONTENT AND IS AWARE
THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE RELEASEES
AND I SIGN IT OUT OF MY OWN FREE WILL.
I acknowledge that if my fee is not paid in full by the day of, my card will be charged for the
balance.

I've read the above and agree.

Medical Emergencies

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I've read the above and agree.

Enter your Full Name: