Registration
Extended Fun Friday Open Gym 6:30 pm - 11:00 pm $40 per child (non-refundable) For boys & girls ages 4 1/2 -13. No jewelry. Must wear athletic/flexible clothing.
Includes pizza & Juice. Children may buy extra snacks and drinks in the Coca-Cola room.

. Gymnastics Fun, Group Games, Costume Contests, Prizes, Food & Drink!

Card will be run at time of registration. No refunds.

Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone:* Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
What kind of dinner would your child(ren) like? Options are Pepperoni, Cheese, Hot Dogs. Multiple children: please list names and dinner type if not all the same. EX.: Mary Hot dog, Daniel Pep*
Are you redeeming any FREE OPEN GYM passes? Must present coupon to receive discount. If not received, the full amount will be charged. *
If Yes, what kind? ( Fully punched Fun Friday Loyalty card, Birthday coupon, $15 off discount for each)
Is the child(ren) coming from the After School program, Camp or class directly to Extended Fun Friday?*
Questions/Comments
 
Additional Information:
 
Disclaimer/Waiver
(Read Carefully Before Signing)

I, parent/guardian, on behalf of myself and my child understand that by signing this document I, individually, and on behalf of my child, assume all risks for any harm, injury, or damage that may befall my child as a result of, or in connection with, participation at Powerhouse TNT Gymnastics, whether foreseen or unforeseen, and I that still wish my child to participate in said.


I hereby affirm that I understand that gymnastics is an inherently dangerous activity, and that I am aware of the risks associated in participating in such activates. I am aware that any activity involving motion or height creates the possibility of serious injury, including permanent paralysis, and even death from landing or falling on the head, neck or any other body part, and nonetheless agree to proceed with such activities. I give my child my express consent and permission to participate in any and all activities at Powerhouse TNT Gymnastics. I further understand that Powerhouse TNT Gymnastics is not a childcare facility, and participation in any activity is purely voluntary. I also understand that Powerhouse TNT Gymnastics is not my insurer, nor my child’s insurer. I understand that it is my responsibility, not that of Powerhouse TNT Gymnastics, to pay any medical bills resulting from injury, or to otherwise cover my child’s damages from any injury.

I understand that by signing this document I, individually and on behalf of my child, assume all risk in connection with said activity for any harm, injury, or damage that may befall my child as a result of participation at Powerhouse TNT Gymnastics, whether foreseen or unforeseen, and I still wish to proceed.

I understand and agree that Powerhouse TNT Gymnastics may NOT be held liable in any way for any occurrence that may result in injury, death, or other damages to my child, me, or my family, heirs, or assigns, and, in consideration of being allowed to enroll in gymnastics activities, I, individually, and on behalf of my child, hereby personally assume all risks in connection with said activities, for any harm, injury, or damage that may befall me or my child while enrolled in gymnastics, including all risks connected with said, whether foreseen or unforeseen; and further to save and hold harmless Powerhouse TNT Gymnastics, and any persons employed by said, from any claim by me, or my child, family, estate, heirs, or assigns, arising out of my child’s enrollment and participation in gymnastics.

I DO HEREBY, ON BEHALF OF MYSELF AND MY CHILD, EXEMPT, RELEASE, AND INDEMNIFY POWERHOUSE TNT GYMNASTICS, IT’S TEACHERS, EMPLOYEES, STAFF, GYM, AND ANY AND ALL AFFILIATES THEREOF, FROM ALL LIABILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH CAUSED BY ANY NEGLIGENCE (INCLUDING NEGLIGENCE PER SE AND GROSS NEGLIGENCE), INCLUDING IT’S OWN NEGLIGENCE, AS WELL AS ANY INTENTIONAL TORTS, AND FOR ANY AND ALL INJURIES SUSTAINED BY ITS EMPLOYEES. IN THIS REGARD, I ALSO AGREE TO INDEMNIFY POWERHOUSE TNT GYMNASTICS FROM ANY LAWSUIT OR CLAIM MADE AGAINST IT, SHOULD IT RELATE TO DAMAGES SUFFERED BY ME OR MY CHILD, OR AN INJURY CAUSED BY MY CHILD, INCLUDING COSTS OF DEFENSE, AND THE AMOUNT OF ANY SETTLEMENT OR JUDGMENT, INCLUDING PRE- AND POST- JUDGMENT INTEREST.

I further state that I am of lawful age and legally competent to sign this affirmation, indemnification, and release, and am the parent or legal guardian of said child; that I understand the terms herein are contractual and not mere recitals; and that I have signed this document of my own free act, which I have also read.

I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS AFFIRMATION AND RELEASE BY READING IT BEFORE I SIGNED

I've read the above and agree.
 
Audio and Image Consent
By your attendance in class, you are granting your permission for you and your child to be filmed, audio taped, or photographed by any means and are granting full use of your likeness, voice, and words without compensation.
I've read the above and agree.
 
Late Pick Up Fee
I understand that the times for this event are from 6:30-11:30pm, unless otherwise published, and that there is a late fee of $10.00 for every 5 minutes that I am late in picking up my children.
I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*