Registration
Special 4 hr. event includes free-play in gym including trampolines and inflatable Kiddiepillar. Pizza and fresh veggie or fruit. Cost per child: $45 for non-enrolled, $40 for enrolled. Sibling discounts applied. Ages 4 - 12
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
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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:
Please tell us how you heard about Energy.*
Does you child have any food allergies?*
Does your child have any medical conditions of which the staff should be aware?*
 
Additional Information:
 
Assumption of risk
BY SIGNING THIS AGREEMENT, 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.

AUTHORIZATION OF MEDICAL CARE - In case of injury or illness during participation, I authorize and desire medical care for myself or my child at the discretion of the attending physician. I accept responsibility for all associated expenses.

PARENT RESPONSIBILITY TO SUPERVISE - When I visit Energy Fitness & Gymnastics, or am involved in any related activity involving parental presence or participation, I understand and accept the responsibility, and any associated liability, of constantly supervising, controlling, and restricting activities as necessary to assure safety of the children I bring and myself.

PHOTOGRAPHS AND STATEMENTS - I authorize use of my own and my child's visual image and statements in newsletters, posters, and other advertising.

VALID DATES - These agreements, waivers, and authorizations will remain valid and in force as long as and whenever my child, myself, or any family member participates in any activity at or with Energy Fitness & Gymnastics.

AGREEMENT TO PAY - I understand there are no refunds, credits, or guaranteed make-ups for missed classes due to personal reasons or inclement weather, and I am obligated to pay full tuition once a session begins. I accept the responsibility of paying for any damage to facility and equipment caused by myself

I've read the above and agree.
 
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Credit Card Verification:
   
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