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3 hr. Event includes free-play in gym including trampolines and inflatable Wacky Maze. Pizza and fresh veggie or fruit. Cost per child: $35 for non-enrolled, $30 for enrolled. Sibling discounts applied. Ages 4 - 12

Event:

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Family Information

	First Name:*	Last Name: *
	Relation to student*
	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:


Please tell us how you heard about Energy.*
Does your child have any food allergies?*
Does your child have any medical conditions of which our staff should be aware?*

Additional Information:

Assumption of risk

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BY SIGNING BELOW, I acknowledge reading, understanding, and accepting the statements herein.

AGREEMENT TO PARTICIPATE AND LIABILITY WAIVER - I understand gymnastics and other sports activities involve risk and possible injury, including but not limited to paralysis, death, emotional distress, or damage to myself, to property, or to third parties.

I understand that it is my responsibility as an adult participant or parent not to participate or allow participation if there are any physical, emotional, and behavioral or other problems that might compromise safe involvement. I understand that Peak Fitness LLC. dba/Energy Fitness & Gymnastics does not carry medical insurance for participants and forever release the corporation, staff, owners, facility, and equipment owners, and other related parties from the responsibility or liability for insurance deductibles, medical expenses, and/or other damages incurred by my child, myself, or other family members while participating or visiting the facilities, parking area, or traveling to or at a related activity. I expressly agree and promise to accept and assume all of the risks existing in this activity as outlined above.

My participation or my child's participation in this activity is purely voluntary, no person(s) are forcing me or my child to participate and I elect of my own volition to participate or have my child participate with full knowledge of the inherent risks involved.

I hereby voluntary release, forever discharge, and agree to hold harmless and indemnify Peak Fitness LLC. dba/Energy Fitness & Gymnastics from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my participation or my child's participation in this activity, including those allegedly attributable to the negligent acts or omissions of Energy Fitness & Gymnastics or their staff.

Should Energy Fitness & Gymnastics, or anyone acting on their behalf, be required for any reason to incur attorney fees and costs to enforce this agreement, I agree to indemnify and reimburse Energy Fitness & Gymnastics for such fees and costs.

I understand that injuries can and do occur and that health insurance is a requirement. I certify that I have health, accident, and liability insurance to cover any bodily injury or property damage I or my child may cause or suffer while participating in the sport of gymnastics or any other activities in or related to Energy Fitness & Gymnastics, including use of the Complimentary Cardio machines, or else I agree to indemnify and reimburse Energy Fitness & Gymnastics for such fees and costs as incurred.

COVID -19: My/Our child/children has/have no physical or health conditions that would limit his or her participation in athletic activities or present a known and undue risk of transmitting any virus and/or disease to other participants in these activities. I/We hereby give permission for my/our child/children to have their temperature taken before participation in activities at PEAK FITNESS, LLC, dba Energy Fitness and Gymnastics (EFG); participate in activities at EFG; and to work on all of the necessary equipment. We understand EFG will keep confidential information regarding participants’ temperatures and reserves the right to exclude individuals from participation in activities based on this information in accordance with its policies. I/We understand that EFG may inform other participants of any confirmed diagnosis of COVID-19 (or other transmittable virus/disease), to the extent they may have been exposed, but will maintain confidentiality to the extent possible; we waive all privacy-related claims based on such disclosure(s). I/We assume all risks and hazards incidental to the conduct of this activity and transportation to and from this activity. In case of emergency, the EFG, staff has my/our permission to use their judgment with regard to treatment until I/we can be contacted. Moreo

I've read the above and agree.

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