Registration
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Emergency Contact Info
Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
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Disabilities (Leave blank if NONE):
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Add New Student #2:
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Disabilities (Leave blank if NONE):
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Add New Student #3:
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Student's First Name:
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Disabilities (Leave blank if NONE):
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Medications (Leave blank if NONE):
Add New Student #4:
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Student's First Name:
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Female
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Birth Date:
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(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
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Student's First Name:
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Last Name:
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Student Gender:
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Female
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Birth Date:
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Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Additional Information:
Notice of Risk / Release and Waiver of Liability
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We, the staff of, owners and representative of FLGA Inc., d/b/a Head Over Heels Gymnastics, Head Over Heels Gymnastics of Vestal, LLC, D & J of Vestal, LLC (collectively, "HOHG") & Ninja Zone recognize our obligation to make our students and their parents aware of the risks and hazards associated with the sports of gymnastics, tumbling and cheerleading. Students may suffer injuries, possibly minor, serious, or catastrophic in nature. Gymnastics, tumbling and cheerleading can be dangerous and lead to injury! Parents should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and the coach's instructions. HOHG & Ninja Zone, its coaches and other staff members will not accept responsibility for injuries sustained by any student during the course of gymnastics, tumbling, or cheerleading instruction, or open workouts or in the course of any exhibition, competition, or clinic in which he or she may participate or while traveling to or from the event. By signing this form, I acknowledge these risks of injury, and I agree that HOHG & Ninja Zone, its staff, owners and representatives will not be responsible for any such injuries. With the above in mind, and being fully aware of the risks and possibility of injury involved, I consent to have my child or children participate in the programs offered by HOHG & Ninja Zone. I, my executors or other representatives, waive and release all rights and claims for injuries or damages that I or my child may have against HOHG & Ninja Zone and/or its staff, owners or representatives whether paid or volunteer. I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage, which I consider adequate for both my child's protection and my own protection. I have read and also understand HOHG's & Ninja Zone's registration information and policies. I also understand that it is the parents' responsibility to warn the child about dangers of gymnastics and injury. The parents should warn the child according to what the parent feels is appropriate. HOHG & Ninja Zone will only warn the child through "safety messages" and our teaching style and progressions. Any and all Ninja Skills will be conducted in a safe gym environment and will hold HOHG & Ninja Zone harmless of any injuries incurred in and outside gym areas.
I've read the above and agree.
Medical Emergencies - Permission to Treat
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I fully understand that HOHG's & Ninja Zone's staff, owners and representatives are not physicians or medical practitioners of any kind. With the above in mind, I hereby grant consent and permission to HOHG's & Ninja Zone's staff, owners and representatives to render temporary first aid to my child or children in the event of any injury or illness, and if deemed necessary by the HOHG & Ninja Zone staff to call our doctor and to seek medical help, including transportation by a HOHG & Ninja Zone staff member and/or its representatives, whether paid or volunteer, to any health care facility or hospital, or the calling of an ambulance for said child should the HOHG & Ninja Zone staff deem this to be necessary.
I've read the above and agree.
Acknowledgement of Policies (MONTHLY CLASS ENROLLMENT)
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CONTINUOUS ENROLLMENT, MONTHLY TUITION & AUTOMATIC PAYMENT SYSTEM • At the Time of Registration for a class, the FIRST MONTH'S TUITION IS DUE. BY REGISTERING FOR A CLASS AT ANY TIME, ALL STUDENTS ARE CONTINUOUSLY ENROLLED IN THAT CLASS FOR ALL FUTURE MONTHS. • Months may have 3, 4, or 5 classes. Tuition is not prorated or increased depending on the number of classes in a month due to holidays, inclement weather or scheduled gym closings. Holiday and gym closings are already factored into your monthly tuition and there are NO make-ups for the Scheduled Closings. (Please check our website for scheduled holidays and scheduled gym closings.) • Your child may make-up a missed class (see Make-up Policy). However, missed classes cannot be transferred to future months in place of tuition. There are no tuition adjustments for missed classes. • HOHG uses an Automatic Payment System and Tuition is paid every month on a continuous basis. On the 20th of each month, tuition for the following month will be charged to the credit/debit card number we have on file for you in our secured system. (e.g., on November 20th, December's tuition will be drawn) If the 20th falls on a Sunday your card will be charged on Monday the 21st. • Alternate payment methods - If some months you'd rather we didn't use your card on file, simply pay before the 20th of the month for the following month's tuition with a check, cash or an alternate credit card. Returned Check Fees - There is a $30 charge when a check is returned to us. We will NOT redeposit your check. The only remedy for this oversight is CASH or CHARGE, and must be paid by your child's next class meeting. WITHDRAWAL POLICY • YOU MUST DELIVER A NOTICE OF WITHDRAWAL VIA EMAIL TO THE OFFICE BY THE 19TH OF THE CURRENT MONTH TO WITHDRAW FOR THE FOLLOWING MONTH. (e.g., to withdraw for the month of January a notice of withdrawal VIA EMAIL MUST be received on or before December 19th). This policy enables a more efficient billing process and manageability of accurate class enrollment. If a notice of withdrawal via email has not been received by the 19th of the month, your card will be charged on the 20th for the following month's tuition. NO EXCEPTIONS will be given to this policy! This Policy is STRICTLY ENFORCED! • ONLY NOTICES OF WITHDRAWAL VIA EMAIL WILL BE VALID. VERBAL WITHDRAWALS ARE NOT ACCEPTED. It is not sufficient to verbally inform your child's coach, the front desk or leave a message on the answering machine. MAKE-UP POLICIES Just like college, your tuition pays for a class spot, REGARDLESS OF ATTENDANCE. However, as a courtesy, our program offers make-ups when doing so does not jeopardize the safety or integrity of the class. Please read the restrictions and scheduling procedure below. • Make-up classes MUST be scheduled within 60 days of your child's absence. After 60 days, a make-up class will no longer be available. • Only 2 make-ups may be scheduled at a time • We will make every effort to provide a make-up in a class at your child's level. There are some classes that are so advanced or specialized that we only offer one class a week. In order to make-up one of those classes you will need to take the make-up in a closely related class. • Make-ups are offered for inclement weather closings. All holiday closings are factored into the monthly tuition and make-ups for these closings cannot be scheduled. • Make-ups must be taken while a child is enrolled. Once a child withdraws from the program, all make-ups are forfeited. • If your child is enrolled in multiple classes and your child withdraws from one of the classes (but still stays enrolled in the other), the make-up classes for the withdrawn class will be forfeited. • Make-ups are not drop-in situations and MUST be scheduled in advance. • Once a make-up is scheduled, it is up to you to get your child to that class; if you miss that make-up class, it still counts as a make-up. Make-ups are a privilege. We reserve the right to refuse a make-up i
I've read the above and agree.
Acknowledgement of Policies (PRIVATE LESSONS)
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• All Private Lessons must be paid for in advance at the time they are scheduled (prior to the date of the lesson). By paying for a 30 minute, 45 minute, or 1 hour long private lesson, you are not only reserving time in our gymnastics facility, but also reserving the time of a member of our staff. • All Private Lessons have a 8-hour cancellation policy. If you have to cancel your lesson, contact the coach 8 hours prior to your lesson and your payment will be applied to a future lesson. If you do not contact the coach to cancel the lesson, the fee will be forfeited and cannot be used towards a future lesson.
I've read the above and agree.
Acknowledgement of Policies (KIDS CAMP)
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• By registering online, you are authorizing HOHG to process your credit card for the entire tuition amount. • Kids Camp registrations can only transferred prior to the event and if space is permitted. • Kids Camp registrations are non-refundable.
I've read the above and agree.
Acknowledgement of Photo/Video Release
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By Selecting "Yes" on this policy, you are confirming that you UNDERSTAND the Head Over Heels Photo/Video Policy. On the Electronic Registration Form, there is place to select either Yes or No to permit the collection and use of photos and videos. PHOTO/VIDEO POLICY - Head Over Heels may take either photos or videos of students which may be used on the Head Over Heels Gymnastics website, Facebook page, Instagram Account, in newsletters and publications as well as distributed to members. These photos or videos may be used by Head Over Heels Gymnastics to promote Head Over Heels Gymnastics in the future.
I've read the above and agree.
COVID-19 Addendum
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This is an Addendum to the Waiver you have previously signed with us as a member. By signing this Addendum, you understand and agree to the following terms: You are aware that by entering this facility, you agree to fully accept all known and unknown risks, including the potential risk of exposure to respiratory illnesses such as the coronavirus (COVID-19). The coronavirus is primarily transmitted via exhaled respiratory droplets, most often through coughing and sneezing. These droplets can travel up to six feet in the air and are more commonly transmitted between persons rather than from equipment to persons. Although we regularly sanitize our equipment and presently are using enhanced cleaning methods and requiring social distancing in our facility, you understand that you may be exposed to the coronavirus or its symptoms through no fault of our own. Known coronavirus symptoms include fever, coughing, shortness of breath, pneumonia, kidney failure, and may include other symptoms, stroke or even death (collectively, "Symptoms"). You understand and agree that you will hold us harmless from and you will not hold us liable for you or any of your family members contracting COVID-19 or suffering any real or perceived Symptoms of COVID-19 or any other disease, illness, or condition, nor for exacerbating any existing symptoms, and you agree to accept fully all risks of entering the facility, using the equipment, working with coaches/instructors, attending classes, and/or interacting with or being exposed to our staff, other members or any other persons who are present in the facility. You also understand and agree that although we are requiring social distancing, if a coach/instructor or staff member, in their sole judgment, deems it necessary or appropriate, he/she may spot a student for their safety even if such spotting involves a breach of social distancing rules.
I've read the above and agree.
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