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90 Minute Open Gym (11am-12:30pm) Bake Sale in Cafe Proceeds Benefit Horses Bring Hope, therapeutic riding facility in S. Kingstown
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Family Information
First Name:* Last Name: *
Home Phone:* Cell #: Work #:
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Address: *
City: * State: * Zip: *
Emergency & Pick Up Authorization Contacts Names & Numbers*
Students entered below will be added to your family's account
Additional Information:
Assumption of Risk
I recognize that participation in activities such as gymnastics, tumbling, trampoline, martial arts, dance, cheerleading, ball sports, rock climbing, and outdoor play can result in severe injuries, permanent paralysis, brain damage, or even death. Sports participation can be dangerous. I am also aware that participation in certain activities including but not
limited to day camps involves transportation to and from field trips and such transportation could cause injury or death in a vehicular accident. Being fully aware of these dangers, I hereby give consent for my child(ren) to participate in any and all Aim High Academy Inc. and affiliated entities (Aim High) programs and activities and I ACCEPT ALL RISKS associated with such participation.

I've read the above and agree.
Waiver of Liability
On behalf of myself and my child(ren), I accept all such risks and promise not to sue, and forever release Aim High Academy, Inc. each of their respective officers, directors, shareholders, employees, contractors, invitees, licensees, and agents ("you") from all liability for damages or injuries incurred as a result of participation by my child(ren) or myself. This includes those injuries resulting from acts of negligence by you. I also waive all rights any third party may otherwise have to pursue claims against you on my behalf (including the right of subrogation). If, despite this agreement, I or any third party on my behalf makes a claim against you, I will defend, hold harmless and reimburse you for such claim and liabilities as a result of such a claim.

I've read the above and agree.
Medical Authorization
In the event of an accident or emergency I AUTHORIZE MY CHILD(REN) TO BE TRANSPORTED TO A MEDICAL FACILITY FOR TREATMENT, at my cost, and will hold harmless in your management of such accident or emergency. I agree to provide for all medical expenses which may be incurred by myself or my child(ren) as a result of any injury while on your premises or while under your care

I've read the above and agree.
I am aware that individual and group publicity photos and videos are taken from time to Photo Release time and in consideration for my or my child(ren) participation I hereby grant permission for my child(ren) likeness to be used in Aim High Academy's publicity or advertising.

I've read the above and agree.
Parent/Guardian Signature
I have read and understood the above ASSUMPTION OF RISK, WAIVER OF LIABILTY, MEDICAL AUTHORIZATION, and PHOTO RELEASE. In addition, I confirm I am the parent/guardian of this registrant(s).

I've read the above and agree.
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