Registration

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This Back Handspring Clinic is designed for athletes working towards a back handspring and athletes looking to improve their back handspring technique. This clinic will consist of non-stop drills, conditioning, and spotting to assist in the basic foundations of a back handspring, which is an essential tumbling skill for backwards tumbling.
Athletes MUST have a strong handstand and backbend kick over in order to participate in the clinic.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

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

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

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

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)
	Student Email:
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Primary Doctor:
	Liability Agreement Date:

Questions/Options:


Does your athlete have a strong backbend kickover? (Yes or No)*
Does your athlete have a strong handstand? (Yes or No)*
Does your athlete have a strong cartwheel?*

Additional Information:

Liability Waiver

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In consideration of my use of the exercise equipment and facilities provided by Black Watch Sports Performance, LLC ("BlackWatch"), I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that BlackWatch and its insurers, members, managers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me, or my guest in, on, or about the premises, or as a result of the use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of BlackWatch. By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me or my guest, and I hereby fully and forever release and discharge BlackWatch, its insurers, members, managers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said equipment and facilities. I expressly agree to indemnify and hold BlackWatch harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me or my guest. I agree to be solely responsible for safety and well-being of my guest and myself. I understand that BlackWatch does not provide supervision, instruction, or assistance for the use of the facilities and equipment for Open Gym, Birthday Parties, and facility rental. I agree to comply with all rules imposed by BlackWatch regarding the use of the facilities and equipment. I agree to conduct myself in a controlled and reasonable manner at all times, and to refrain from using any equipment in a manner inconsistent with its intended design and purpose. I understand and acknowledge that the use of exercise equipment involves risk of serious injury, including permanent disability and death. I understand and agree that BlackWatch is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises. I understand any exercise program participant should seek medical approval prior to starting any new regimen. It is understood that the participants and any guests are cleared to participate in the activities they will engage in. I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.

I've read the above and agree.

Cancellation Policy

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Vulcan Performance Consent Form

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I've read the above and agree.

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