Registration
Open Gym
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Parent Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
In case of emergency, who should we contact if the adults listed above are unavailable*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Introduction
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Scope and Continued Application
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Use of Premises for Activity Only
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Acknowledgement of Danger
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Acceptance of Responsibility
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Assumption of Risk
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Physical Contact Acknowledgement
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Publicity Release
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Video Surveillance
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Audio/Visual Publicity Waive
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Copyrights
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Responsibility for Personal Property
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No Representations by Company
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Service Animals
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Consent to Medical Treatment
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Release from Liability and Waiver
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Indemnification
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Covenant Not to Sue
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Transition
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Waiver of Terms
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Survival
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Governing Law and Venue
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Compliance with Laws
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Severability
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Entire Agreement; Modification; Binding Effect
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Parental Consent
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Conclusion
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Enter your Full Name: *   
 
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