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Students entered below will be added to your family's account
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Release of Liability
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RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT AND MEDICAL AUTHORIZATION
In consideration of participating in the programs offered by Performance Plus Events LLC and TMB Services, LLC, DBA/SparkZone Athletics/Ignite Gymnastics/Dynamite Kids, I represent that I understand the nature of this activity and that my child(ren) are in good health, and in proper physical condition to participate in such an activity. I fully understand that this activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my child(ren)’s 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 child(ren) participation in the activity. I hereby release, discharge, and covenant not to sue Performance Plus Events LLC and TMB Services, LLC, DBA/SparkZone Athletics/Ignite Gymnastics/Dynamite Kids, its Respective administrators, directors, agents, officers, volunteers, and 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 child(ren)’s 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 the minor's behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability , damage, or cost, which any may incur as the result of such claim.
I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, and 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 effect.
CONSENT TO MEDICAL TREATMENT: In the event of an accident or emergency I hereby give permission to Performance Plus Events LLC and TMB Services,LLC, DBA/SparkZone Athletics/Ignite Gymnastics/Dynamite Kids, employees to administer first aid to my child(ren) to the extent they deem appropriate. I also grant permission for the Performance Plus Events LLC and TMB Services,LLC, DBA/SparkZone Athletics/Ignite Gymnastics/Dynamite Kids, staff to transport or arrange for transportation by ambulance to a hospital for medical care for my child(ren). I understand efforts will be made to contact me before any action is taken, but if this is not possible, transportation to emergency services will be made and I will accept the expense. I hereby agree to be personally responsible for payment of all medical and dental expense including transportation, which may be incurred by myself or on behalf of my child(ren) as a result of any injury sustained while participating at Performance Plus Events LLC and TMB Services, LLC, DBA/SparkZone Athletics/Ignite Gymnastics/Dynamite Kids, including future medical and dental expenses related to such injury. ?The parents or legal guardian of the child(ren) will accept all expenses of such care.
I've read the above and agree.
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Billing Authorization
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I represent and warrant that if I am purchasing something or paying for a service from this facility or from other merchants through this facility that (i) any credit card or bank account draft (ACH Draft) information I supply is true and complete, (ii) charges incurred by me will be honored by my credit card company or financial institution, and (iii) I will pay the charges incurred by me at the posted prices, including any applicable taxes, fees, and penalties.
I hereby authorize (if online payment is made or autopay information is provided) this facility to charge my ACH draft, or credit card account. I understand that a 2 week notice is required to terminate billing and I am responsible for payment whether or not my student attends classes until I notify this facility to drop my student from class(es).
Should I dispute a charge through my financial institution this will constitute a breach of contract possibly resulting in, but not limited to, penalties, additional fees, collection, legal action, and/or termination of any and/or all current and future services.
I've read the above and agree.
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Credit Card Verification: |
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