Registration
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Kid's Night Out (KNO) is a structured evening of fun activities, gymnastics, themed crafts and games! Pizza and ice cream will be provided for all participants. Apex KNO is a great opportunity for some drop-in fun, open to girls and boys, members and non-members, ages 5 to 13. Siblings get 20% off! Drop off your children at Apex KNO and have a night out for yourself!
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Type
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Aunt
Brother
Doctor/Physician
Father
Friend
Grandma
Grandpa
Guardian
Mother
Nanny
Parent
Scholarship Contact
Sister
Spouse
Step Father
Step Mother
Uncle
Home Phone:
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Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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Zip:
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Emergency Contact Info (Who should we contact, other than the contact listed above?)
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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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Last Name:
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Student Gender:
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Female
Male
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School District:
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Allergies:
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Medications (Leave blank if NONE):
Primary Doctor:
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Add New Student #2:
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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
Male
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School District:
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Allergies:
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Medications (Leave blank if NONE):
Primary Doctor:
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Add New Student #3:
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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
Male
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School District:
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Allergies:
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Medications (Leave blank if NONE):
Primary Doctor:
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Add New Student #4:
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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
Male
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School District:
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Allergies:
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Medications (Leave blank if NONE):
Primary Doctor:
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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
Male
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School District:
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Allergies:
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Medications (Leave blank if NONE):
Primary Doctor:
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Questions/Options:
The total for KNO $60 per participant, siblings get 20% off.
Additional charge of $5 per child is applied when registering on the day of the event.
Please let us know if your child has any allergies. We provide cheese and pepperoni pizza, juice and ice cream/popsicles. If your child has special diet, please provide food for them.
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Occasionally, we serve ice cream during our event, can your child have ice cream/fruit popsicles?
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Yes
No
Do you have a coupon for this event? If so, what is your coupon number?
Additional Information:
Waiver of Liability
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Assumption of Risk and Release of Liability
In consideration of participating in any class or activity at Apex Gymnastics LLC (Apex Gymnastics of Almaden) I represent that I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in the activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the "releasees"Â named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the Activity. I further acknowledge, understand, appreciate and agree that my participation may result in possible exposure to and illness from infectious diseases, including, but not limited to, MRSA, Influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation and exposure. Release of Liability I hereby release, discharge, and covenant not to sue Apex Gymnastics LLC (Apex Gymnastics of Almaden) its respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES"Â herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the "releasees"Â or otherwise, including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost, which any may incur as the result of such claim. I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect. By agreeing to this I understand that even if I am not participating in gymnastics, cheer, dance, lessons and will not be on the equipment, I may injure myself being in the gym. This could include, but is not limited to stepping off uneven mats and twisting an ankle, broken bones, torn ligaments, spine injuries or even death. I take full responsibility for my actions and agree to pay for any and all medical bills that might arise from an accident at Apex Gymnastics LLC (Apex Gymnastics of Almaden). Should any part or parts of this agreement be held null and void, the gross balance of the gross agreement shall remain valid and maintain its full force and effect. This acknowledgment of risk and WAIVER OF LIABILITY has been read by me and understood completely and signed voluntarily. I am 18 years of age or older.
I've read the above and agree.
Medical Emergencies
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PARENTAL CONSENT AND I, the minor's parent and/or legal guardian, understand the nature of the above referenced activities and the Minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby Release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees from all liability, claims, demands, losses or damages on the minor's account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releases from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasee may incur as the result of any such claim.
I've read the above and agree.
Permission to Treat
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I, the parent or legal guardian of the above-named minor, fully understand that Apex Gymnastics of Almaden (Apex Gymnastics) staff members are not physicians or medical practitioners of any kind. With the foregoing in mind and in the event that any kind of injury or illness should occur to my child while on Apex Gymnastics premises, I hereby authorize Apex Gymnastics staff members to render first aid as deemed necessary in their discretion and/or to seek medical assistance, including calling 911 or otherwise arranging for the transport of my child to an appropriate medical facility for treatment. Additionally, I hereby authorize any trained and licensed medical professional to administer emergency medical treatment to my child should injury or illness occur in my absence. I understand that Apex Gymnastics will make every effort to promptly notify me of any such emergency.
I have read and understand the above Permission to Render Emergency First Aid and I hereby give my express written consent to its provisions.
I've read the above and agree.
Payment/Cancellation
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Payment
Payment is due in full at the time of registration, the total amount due will be charged to the credit/debit card provided below.
Cancellation:
No refunds or credits will be given except with a WRITTEN medical authorization for cancellation on the day of the event.
I've read the above and agree.
Parent/Guardian Signature
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I have read and understand the above WAIVER OF LIABILITY, Medical Emergencies, Permission to Treat, Payment/Cancellation Policy. In addition, I confirm that I am the parent/legal guardian of this registrant(s).
I've read the above and agree.
Enter your Full Name:
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Other Questions/Comments:
Credit Card Verification:
Card Number:
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Visa
Mastercard
Name as it appears on card:
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Nickname:
Card Expiration Month:
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Exp Year:
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Address Line 1:
Address Line 2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
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