Registration
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Pack a water bottle and snack or two! Cash only and to be paid at the door! Cost: $25 and $20 for sibling
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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Home Phone:
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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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)
School:
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Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #2:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (if none leave blank):
Allergies (if none leave blank):
Medications (if none leave blank):
Questions/Options:
I understand that payment is at the door the night of the event - CASH ONLY! $25 per kiddo - bringing a sibling, only $20
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Yes
No
Any allergies we need to be aware of? If yes, please explain. If no, please type in the word "no."
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Additional Information:
Assumption of Risk
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As legal guardian and/or one of the above named persons and/or participants, I recognize that potentially severe injuries, including permanent paralysis or death can occur in sports or activities involving height or motion, including but not limited to inflatable's, gymnastics, tumbling, cheerleading, clinics, camps, private lessons, birthday parties, birthday party guests, bring a friend, play time, field trips, special olympics, swimming, competitions, preschool, group activities, family fun nights, parents night out, trampoline, dance, karate, circuit training, running, free weights, conditioning, obstacle courses, personal training and group fitness.
I've read the above and agree.
Release of Liability
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In consideration for allowing my child and/or myself to use this facility, I, on my own behalf and the behalf of my child and our respective heirs, administrators, executors, and successors, hereby COVENANT NOT TO SUE, and I FOREVER RELEASE Power and Grace, its officers, directors, shareholders, employees or other representatives, whether paid or volunteer, from all liability for any and all damages or injuries suffered by myself or my child while under the instruction, supervision or control of Power and Grace.
I've read the above and agree.
General Policies
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For safety reasons, students are not allowed on the floor or equipment without a staff member of Power and Grace observing and with their consent. When class is over, the students must leave the training area.
2. Parents may observe their child in class but MUST stay in the viewing area.
3. Our insurance does not allow parents and non-registered students in the training area. No parents or non-gymnasts are allowed on the floor. Please keep your other children off the floor and equipment at all times. Power and Grace accepts no responsibility or liability for accidents or injuries for anyone not enrolled in classes at the Gym.
4. No food or drinks are allowed on or near the floor.
5. No shoes and/or gum is permitted on the gym's floor.
6. You are responsible for dropping off and picking up your student on time, if students are picked up late an additional fee will be charged!
7. Families give permission for photographs and videos of named persons and/or participants to be used in print or broadcast media, as deemed appropriate for the promotion of Power and Grace.
Proper Attire
• Girls: Leotard or Leotard and Biker Shorts or tight fitting clothes that will not catch on the equipment.
• Boys: T-shirt and Shorts
• No jewelry with the exception of post earrings.
• Hair must be pulled tightly away from the face.
• No gum.
I've read the above and agree.
Enter your Full Name:
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Other Questions/Comments:
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