Registration
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Ages 5 and up. Open gym is a non-instructional free time for individuals to enjoy extra time working on skills and getting additional exercise in. $10.00 per person. Cash or check only.
Event:
Start Date/Time:
End Date/Time:
Fee per Family:
Room:
*
- denotes required fields
Family Information
First Name:
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Last Name:
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Type
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Doctor/Physician
Father
Grandparent
Guardian
Mother
Other
Parent
Step Father
Step Mother
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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Emergency Contact Info
*
Add New Student #1:
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Student's First Name:
*
Last Name:
*
Student Gender:
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Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Student Photo Release? Y/N:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Student Photo Release? Y/N:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Student Photo Release? Y/N:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Student Photo Release? Y/N:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Student Photo Release? Y/N:
*
Additional Information:
Adult Permission to Participate
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Acknowledgment of Risk and Waiver of Liability
I herby consent to the above person participating in programs offered by Elite Gymnastics Adult, LLC. I understand that potentially severe injuries, including permanent paralysis or death can occur in any activity involving height or motion, including gymnastics and movement education. I also realize that I will be performing and training on all gymnastics events plus various other gymnastics training devices including trampoline and pit. I certify that the above person is in good health and is medically fit to participate. I hereby for myself, my child and/or children, adopted or otherwise, my heirs and executors, forever waive and release any and all rights against Elite Gymnastics Adult, LLC (“EGA”) and Elite Gymnastics Center, LLC (“EGC”), their agents or representatives, for any injury or damages that may be suffered by me, my child and or children, adopted or otherwise, in connection with my association or entry into gymnastics, or other activities sponsored by EGA and EGC. I give EGA and EGC, its members, officers, agents, employees, and any other medical personnel permission to treat myself, my child and/or children, adopted or otherwise, I also give my permission for EGA and EGC to use any images of myself or my children for marketing purposes and for program development without compensation to myself or my child. This acknowledgement of risk and waiver of liability, having been read and understood completely, is signed voluntarily as to its content and intent.
I've read the above and agree.
Minor Permission to Participate
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Acknowledgment of Risk and Waiver of Liability
I herby consent to the above person participating in programs offered by Elite Gymnastics Center LLC. I understand that potentially severe injuries, including permanent paralysis or death can occur in any activity involving height or motion, including gymnastics and movement education. I also realize that my child will be performing and training on all gymnastics events plus various other gymnastics training devices including trampoline and bounce house. I certify that the above person is in good health and is medically fit to participate. I hereby for myself, my child and/or children, adopted or otherwise, my heirs and executors, forever waive and release any and all rights against Elite Gymnastics Center LLC (“EGC”), their agents or representatives, for any injury or damages that may be suffered by me, my child and or children, adopted or otherwise, in connection with my association or entry into gymnastics, or other activities sponsored by EGC. I give EGC, its members, officers, agents, employees, and any other medical personnel permission to treat myself, my child and/or children, adopted or otherwise, I also give my permission for EGC to use any images of myself or my children for marketing purposes and for program development without compensation to myself or my child. This acknowledgement of risk and waiver of liability, having been read and understood completely, is signed voluntarily as to its content and intent.
I've read the above and agree.
Open Gym Rules
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~ No running ~ Leaving the foam in the pit ~ No pushing/touching others ~No standing on high bars
~ Do not try anything you have not been formally taught by a coach ~ No gum ~ No food in the gym
~ No socks or shoes (except non-street cheer shoes) ~ No use of preschool equipment ~ No horseplay
~ Take turns going into the pit and make sure no one is in the pit when entering
~ Land feet first in the pit, not head first ~ One person at a time on the trampoline ~ No jewelry
~ Be respectful of others both verbally (watch what you say) and physically (watch what you do)
~ Long hair must be pulled up and tied back ~ No pushing/shoving others into pit
~ Please use equipment for its intended use only ~ Wear gym clothes (no jeans)
~ When using equipment please make sure your work area is properly surrounded by mats
~ If you are defacing any property or destroying pit foam you will be asked to leave and not be refunded
~ Anyone not following the above rules will be asked to leave and will not be refunded. ~
I've read the above and agree.
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