Registration
Looking for an entertaining evening for your kids while you shop, dine or just take some time for yourself? Bring them to Pickering Athletic Centre for some fun in the gym. The evening includes 1 hour gym time, a craft, snack and a movie.
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/Prov: * Postal Code: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Upgrade to a Platinum member? 25% off FFF nights, 15% off Kids Night Inm I10% off camps, and more! Classic registration fee is $30, Platinum registration fee is $50. Upgrade now?*
 
Additional Information:
 
Assumption of Risk
Participation in physical activities can involve motion, rotation, and height in a unique environment and as such carries with it a certain assumption of risk. I am aware that the sport of gymnastics involves risks including risk of personal injury, death, property damage, expense and related loss, including loss of income. Included in theses risks are negligence on the part of Pickering Athletic Centre Inc., its officers, agents, employees, officials, volunteers, other participants and owners of the facilities where the activities occur. I freely accept and fully assume all such risks and the possibility of personal injury, death, property damage, expense and related loss including loss of income.
I've read the above and agree.
 
Release of Liability
In consideration of Pickering Athletic Centre Inc. accepting my application to participate in this activity, I agree
1. To waive any and all claims that I may have in future against Pickering Athletic Centre Inc. and OTHERS
2. To release Pickering Athletic Centre Inc. and OTHERS from any and all liability for a personal injury, death, property damage, expense and related loss, including loss of income that I or my next of kin may suffer as a result of my participation in this activity, due to any cause whatsoever, including negligence, breach of contract or breach of any statutory duty of care.
3. To hold harmless and indemnify Pickering Athletic Centre Inc, and OTHERS from any all liability for any damage to property of or personal injury to any third party, resulting from my participation in this activity.
4. That this agreement is binding on not only myself but my next of kin, heirs, executors, administrators and assigns.

I've read the above and agree.
 
Permission to Release
I consent to Pickering Athletic Centre/Gymnastics Ontario/Gymnastics Canada to take photographs, videotape or digital recording of me/my child/ward and to use these in any and all print and social media, including Pickering Athletic Centre or Gymnastics Ontario/Gymnastics Canada websites.
I've read the above and agree.
 
Medical Emergencies
The undersigned gives permission for Pickering Athletic Centre, owners, officers, employees, and /or agents to seek emergency medical treatment for the participant(s) in the event they are unable to reach any parents or guardian. The undersigned also agrees that they themselves will be responsible for any financial debt incurred by said action.
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/Prov: Postal Code:*