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End Date/Time:
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Fee per Student:
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Room:
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Family Information |
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Students entered below will be added to your family's account
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Add New Student #1:
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Add New Student #2:
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Add New Student #3:
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Add New Student #4:
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Add New Student #5:
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Additional Information: |
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Release of Liability
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In consideration for allowing my child to participate in Kid's Night Out, I hereby assume all risks associated with the sport and agree to hold Gym Stars Gymnastics Center, its employees and agent, harmless from any and all liability, causes of actions, debts, claims or demands of any nature whatsoever that may arise in connection with my participation in any activities connected with the sport. I am aware that participation in gymnastics, tumbling and/or ninja classes can result in injuries including to the head, neck, spine, arms, legs, ligaments and other areas and aspects of the body. The terms hereof serve as a release and assumption of risk for my heirs, estate, and for all members of my family. I, as the legal parent or guardian, have read the above warning and release and understand the terms. I understand that this sport involves many risks including and not limited to those stated above. In consideration for Gym Stars permitting my child to participate in its program, I hereby agree to hold Gym Stars, its employees and agents harmless from any liability which may arise in connection with participation of my child in activities related to them.
I've read the above and agree.
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Assumption of Risk
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I am aware that participation in gymnastics, tumbling and/or ninja at a Kid's Night Out event will be a dangerous activity involving many risks of injury or death. I understand the dangers and risk of participation include, but are not limited to, death, serious neck or spinal injury, brain damage, serious injury to all organs, injury to all bones, ligaments, muscles, tendons, and all other aspects of the body. I understand the dangers and risks of playing or practicing may result in serious injury, but in serious impairment of future ability to earn a living, engage in business and generally enjoy life. Because of the dangers of the sport, I understand the importance of following the coaches' instructions regarding technique, training and other rules, and agree to obey instruction.
I've read the above and agree.
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Medical Emergencies
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I grant permission to the instructors of Gym Stars Gymnastics to seek appropriate medical attention for my child if they are injured. I understand that attempts to contact myself and others listed on my account will also be made.
I've read the above and agree.
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Payment Policy (KNO)
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I agree that payment for the registration fee for Kid's Night Out is due upon registration. I hereby authorize Gym Stars Gymnastics to charge the debit or credit card or bank account on file for the full amount due for the registration of my child(ren).
I've read the above and agree.
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Other Questions/Comments: |
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Credit Card Verification: |
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Card Number: * |
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Name as it appears on card: * |
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Nickname:
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Card Expiration Month: * |
Exp Year: *
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Address Line 1:
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Address Line 2:
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City:
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State:
Zip:*
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Bank Name: |
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Bank Routing Number: |
(9-digit number)
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Your Account Name: |
(Your name on your bank statement)
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Your Account Type: |
Account Number:
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