Registration
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Come have a little fun with us and see what we're all about. All kids aged 3 - 12 are welcomed to join a free class and we'll have food and vendors as well. It'll be an afternoon of fun & gymnastics!
Event:
Start Date/Time:
End Date/Time:
Fee per Family:
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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Father
Grandparent
Guardian
Mother
Parent
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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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
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
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Add New Student #1:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
School:
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Disabilities (Leave blank if NONE):
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Interested in Classes (Y/N):
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Interested in Private Less. YN:
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Interested in Clinics (Y/N):
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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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Birth Date:
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(format=mm/dd/yyyy)
School:
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Disabilities (Leave blank if NONE):
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Interested in Classes (Y/N):
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Interested in Private Less. YN:
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Interested in Clinics (Y/N):
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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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Birth Date:
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(format=mm/dd/yyyy)
School:
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Disabilities (Leave blank if NONE):
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Interested in Classes (Y/N):
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Interested in Private Less. YN:
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Interested in Clinics (Y/N):
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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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Birth Date:
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(format=mm/dd/yyyy)
School:
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Disabilities (Leave blank if NONE):
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Interested in Classes (Y/N):
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Interested in Private Less. YN:
*
Interested in Clinics (Y/N):
*
Add New Student #5:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
School:
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Disabilities (Leave blank if NONE):
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Interested in Classes (Y/N):
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Interested in Private Less. YN:
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Interested in Clinics (Y/N):
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Questions/Options:
How many guests will be in your party including yourself?
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How many children will be participating in the free class?
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What are the ages of the children participating in the free class?
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Additional Information:
Waiver of Liability, Assumption of Risk & Indemnity
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In consideration of being permitted to participate in any way in any activities of Nasser Gymnastics Academy, Inc. (“NGA”) at any time during the calendar year, for myself, my personal representative, assigns, heirs, and next of kin:
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Acknowledge, agree and represent that I/the participant fully understand the nature of participating in activities of (“NGA”) activities and that I am qualified, in good health, and in proper physical condition to participate in such activities. I further agree and warrant that if at any time I believe the conditions to be unsafe, I will immediately discontinue further participation in the activities.
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I fully understand that: (a) any activities involve risks and dangers of serious bodily injury, including permanent disability, paralysis, and death (“risks”); (b) these Risks and dangers may be caused on my own action or inactions, the actions or inactions of others participating in the Activities, the condition in which the Activities take place, or the negligence of the releases named below; (c) there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; (d) the sudden and unforeseen malfunctioning of any equipment; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation or that of the minor in the Activity.
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I hereby release, discharge, and covenant not to sue, NGA, it’s administrators, directors, agents, o?cers, members, independent contractors, volunteers, 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” 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 or otherwise, including negligent rescue operations; and I further agree that if, despite this release, waiver of liability, assumption of risk, & indemnity agreement 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 litigation expenses, attorney fees, loss, liability, damage, or cost, which may be incurred as the result of such claim.
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I Hereby authorize and give my consent to NGA including any of its instructors to provide emergency medical care and to give authority to any emergency unit, hospital or doctor to render immediate aid as might be required for the treatment of the above-named student in the event of any emergency either on the premises of NGA or during the course of any sports event involving the student as a NGA participant. As Parent/Legal Guardian, I agree to provide health insurance for the minor child(ren) and/or guarantee payment of any and all medical expenses incurred as a result of training, performing, or participation in activities at NGA. All medical expenses incurred will be the responsibility of the participant or participant’s family. I understand that it is my responsibility to inform NGA if my child(ren)’s medical condition changes during the course of enrollment at NGA.
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By acknoledging this waiver, I understand that even though I am not taking lessons and will not be on the equipment I or other guests may be injured being in the gym. I take full responsibility for my actions and agree to pay for any and all medical bills that might arise from an accident at NGA. This also includes outside the building in the parking lot and all surrounding areas.
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Without compensation to me or the student, I hereby grant NGA & its affiliates the absolute right and permission to copyright, publish, and use photographic portraits, pictures, or videos of the minor for use through reasonable promotion of gymnastics and sports conducted by NGA. I hereby waive any right that I or the minor may have to inspect or approve the finished media material as long as the matter is within reason and is not deemed to be socially inappropriate for use of the minor or student.
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I agree to settle my account with NGA for all fees incurred. Should I fail to cooperate, I understand a third party will be involved to settle or collect on my account. Should third party involvement arise, I agree to pay all attorney fees, court costs, and additional fees associated with the collection of my account. I agree to abide by the policies and procedures of NGA and understand that NGA reserves the right to change them at any time.
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I have read this agreement, fully understand it’s terms, 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 e?ect.
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And I, the minor’s parent and/or legal guardian, understand the nature of the above-referenced activities at Nasser Gymnastics Academy, Inc. (“NGA”) and the Minor’s experience and capabilities and believe the minor to be qualified, in good health, and in proper physical condition 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 Releasee’s 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 Releasees from any litigation expenses, attorney fees, loss liability, damage, or any that may occur as a result of any such claim.
I HAVE CAREFULLY READ AND AGREE TO THIS ASSUMPTION OF RISK, RELEASE, AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS INCLUDING THE RIGHT TO RECOVER DAMAGES FROM THE RELEASES IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGES, INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID -19 AT NGA OR PROGRAM AND ALL ILLNESS, INJURY OR DEATH RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS AND IS BINDING ON ME, MY HEIRS, FAMILY, ESTATE, REPRESENTATIVES AND ASSIGNS.
I've read the above and agree.
Dress Code
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In general, students participating in class should where clothes that are non-restrictive, but not baggy.
NO EXPOSED MIDRIFFS
NO SKIRTS, LOOSE SHORTS, SKORTS, or TUTUS
NO BUTTONS, BEADS, ZIPPERS, SNAPS, BUCKLES, OR STRINGS
• All jewelry should be removed, including: barrettes, clips, watches, rings, necklaces, and earrings. Stud earrings may be worn. Secure eyeglasses.
• HAIR PULLED UP: must be pulled up and away from the face.
• BAREFEET: Shoes and socks are to be removed. Everyone must be barefoot.
• REC GIRLS: leotards and unitards are best. Tights, leggings, or non-baggy/loose shorts that do not cover the feet may be worn over a leotard or with an athletic fitted shirt or tank tucked in. NO CROPS
• BOYS: Sport shorts that aren’t large, long, or baggy and a tucked in fitted athletic t-shirt or tank.
• TEAM: hair must be securely pulled up and away from face (including bangs). Leotards and unitards with or without fitted shorts or leggings only. No t-shirts, tanks, or loose clothing.
I've read the above and agree.
Media Release
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Without compensation to me or the student, I hereby grant NGA & its affiliates the absolute right and permission to copyright, publish, and use photographic portraits, pictures, or videos of the minor for use through reasonable promotion of gymnastics and sports conducted by NGA. I hereby waive any right that I or the minor may have to inspect or approve the finished media material as long as the matter is within reason and is not deemed to be socially inappropriate for use of the minor or student.
I have read this agreement, fully understand it’s terms, 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 e?ect.
I further expressly agree that the foregoing MEDIA RELEASE is intended to be as broad and inclusive as is permitted by applicable law and that if any portion thereof is held invalid, it is agreed that the balance will, notwithstanding, continue in full legal force and effect.
And I, the minor’s parent and/or legal guardian, understand the nature of the above-referenced activities at Nasser Gymnastics Academy, Inc. (“NGA”) and the Minor’s experience and capabilities and believe the minor to be quali?ed, in good health, and in proper physical condition 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 Releasee’s 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 Releasees from any litigation expenses, attorney fees, loss liability, damage, or any that may occur as a result of any such claim.
I HAVE CAREFULLY READ AND AGREE TO THIS ASSUMPTION OF RISK, RELEASE, AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS INCLUDING THE RIGHT TO RECOVER DAMAGES FROM THE RELEASES IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGES, INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID -19 AT NGA OR PROGRAM AND ALL ILLNESS, INJURY OR DEATH RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS AND IS BINDING ON ME, MY HEIRS, FAMILY, ESTATE, REPRESENTATIVES AND ASSIGNS.
I've read the above and agree.
Facility Policies
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PARENTS, SPECTATORS, & CHILDREN IN THE FACILITY:
No spectator should speak to any student or coach while they are on the floor. If a coach needs assistance, they will come to you.
Only USA Gymnastics certified coaches and actively enrolled students are allowed on the floor at any time. Per USA Gymnastics policies, parents, spectators, nor non-enrolled students are ever allowed on the floor.
Parents are responsible for the behavior and safety of their child(ren) while on the premises of NGA, including but not limited to bathrooms, waiting areas, parking lots, etc.
Students should not arrive more than 5 minutes prior to the beginning of class and should be picked up immediately when the class ends. Children must NEVER be left unattended in the facility.
Students must be escorted in and out of the building by a guardian and will not be allowed outside of the gym without one. You cannot pick up and drop off from the parking lot.
Children not participating in class must sit with their parents during class time in the designated areas. They are not allowed to roam freely through the gym facility at any time.
I've read the above and agree.
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