Registration
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Come join the fun! Open gym from 6:30-8:30pm.
Please wear gymnastics attire and/or t-shirt and shorts.
There will be games, inflatables, crafts, and more!
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Family Information
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Last Name:
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Emergency Contact Info (Not Contact #1 or #2)
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Students entered below will be added to your family's account
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Allergies (Leave blank if NONE):
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Allergies (Leave blank if NONE):
Primary Doctor:
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Student's First Name:
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School:
Allergies (Leave blank if NONE):
Primary Doctor:
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Questions/Options:
Food Allergies?
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Additional Information:
Newburgh Tumbling Waiver
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Release of Liability
In consideration of allowing the previously-declared participant(s) to begin participation in tumbling, trampoline, double-mini trampoline, tumble-trak trampoline and pre-school gymnastics, cheerleading, birthday parties, camps, inflatable and open gym at Newburgh Tumbling while on the premises and property of Newburgh Tumbling, the undersigned, for themselves, and/or being the legal and acting guardian of participant(s), acting for themselves and on the behalf of the participant(s), release and hold harmless Newburgh Tumbling, its owners, and employees from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant(s) and/or the undersigned, while in or upon the premises upon which Newburgh Tumbling is conducted.
I've read the above and agree.
Assumption of Risk
Participation in physical activities can involve motion, rotation, and height in a unique environment and as such carries with it a certain assumption of risk. The undersigned and the participant(s) choose to voluntarily enter upon said premises under the control of said company, knowing their present condition and knowing that said condition may become more hazardous and dangerous during the time the participant(s) or the undersigned is upon said premises. The undersigned and the participant(s) voluntarily assume any and all risks of loss, damage, or injury that may be sustained by the participant(s) and/or the undersigned or any property owned by them while on or upon said premises described above. The company may, but shall not be obliged to, carry insurance on the participant(s), and the existence of insurance shall not change, alter, or increase the liability of the company to the participant and the undersigned or affect the terms of this Release. This release also applies to adults helping in the parent and tot class. In signing this Release, the undersigned acknowledges:
a) That he/she has read thoroughly and understands completely, the therms of Registrations and Release and signs it voluntarily.
b) That the undersigned signing either for themselves, or as Legal Guardian is, in fact, the true and legal guardian and has the consent of the participant.
I've read the above and agree.
Medical Release
The undersigned gives permission for Newburgh Tumbling, its owners, officers, employees, and/or agents to seek emergency medical treatment for the participant(s) in the event they are unable to reach any parent or guardian. The undersigned also agrees that they themselves will be responsible for any financial debt incurred by said action.
I've read the above and agree.
Marketing Release
I understand that my child's likeness may be used in Newburgh Tumbling ads, videos website material, Newburgh Tumbling facebook page, or various other marketing. These images will be used for Newburgh Tumbling purposes only, and will not be given or sold to outside companies or individuals.
I've read the above and agree.
I've read the above and agree.
Additional Liability Waiver - Illness
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RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK; AND INDEMENITY AGREEMENT
("AGREEMENT")
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 or I am unable to safely perform any activity, I will immediately discontinue participation in the activity.
I fully acknowledge, understand, appreciate and agree, 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 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.
I hereby release, discharge, and covenant not to sue your business, its's administrators, directors, agents, officers, volunteers, employees, contractors, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of the premises on which the activity takes place, (each considered one of the "RELEASEES" herein) from all liability, claims, demands, losses, damages, on my account caused or alleged to be 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, waiver of liability, and assumption of risk, I or anyone on my behalf, makes a claim against any of the RELEASEES, I will indemnify, defend, and hold harmless each of the RELEASEES from any loss, liability, damage, or cost, which any may incur as the result of such a claim.
I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, and I 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. I agree that if any portion of this Agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.
PARENTAL CONSENT I, hereby covenant and promise that I am the minor's parent and/or legal guardian, and on behalf of myself and the minor, 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 further understand the risk of exposure to injury and/or infectious diseases, for myself and my child, as a participant, spectator at events, classes or our presence at the facility. I hereby release, discharge, covenant not to sue and AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS each of the RELEASEES from all liability, claims, demands, losses or damages on the minor's or my account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including, but not limited to injury, negligent rescue operations, and/or exposure to infectious diseases and I 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
I've read the above and agree.
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