Great Summer Gymnastics Camp for ages 7 - 18! All levels welcome! Please note that the full camp payment will be charged to the credit card you've placed into the registration. If for some reason you need to cancel your enrollment,you must do so prior to June 25 to receive a partial refund. A minimum deposit of $25 will be forfeited.
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)
Students entered below will be added to your family's account
Student's Tee Shirt Size - Please choose from Youth Small, Med, or Large . . . OR . . .Adult Small, Med, or Large*
Please tell us the level of gymnastics experience - - High school, JO (what level), Xcel (what level), Recreational Classes (what level), No experience*
Additional Information:
Assumption of Risk
As a condition to participation in the Tumble 4 U, Inc, d/b/a Power & Grace Gymnastics training and other activities, it is necessary that the Participant and/or Parent/Legan Guardian take full responsibility for any permanent or temporary injuries, extensive and severe bodily injury, paralysis, dismemberment, disability, death or other casualty or damage of any nature whatsoever, known or unknown, which may be suffered in the course of the Activities including, but not limited to, Damage caused by the negligence of Power & Grace, its agents, employees or representatives.
In this regard, I for myself, and on the behalf of my heirs, assigns, personal representatives, and next of kin, by my signature here, hereby acknowledge and agree that the Activities invole inherent risk of Damage, and hereby assume and accept, on behalf of the Participant and anyone whom might claim by, under or through the Participant, all risk of Damage to the Participant arising out of the Activities.

I've read the above and agree.
Release of Liability
By my execution of the Waiver and Release, Power & Grace and its employees, agents, officers, directors, affiliated companies and event sponsors are hereby RELEASED AND FOREVER DISCHARGED from any and all claims, losses, liabilities, causes of action, judgments, fines, penalties, right to payment, costs and expenses incurred in connection with any type of Damage arising out of one or more of the Activities. I understand that I am responsible for any costs incurred that are not covered by my insurance.
By execution of this Waiver and Release, I am representing and warranting that:
1. I am the parent and/or the leagally authorized guardian of the Participant or I am a Participant of the age of majority if executing this Waiver and Release for myself;
2. The Participant is covered with health and accident insurance in sufficient amounts and in such form as to cover the Participant in the event of any Damage arising out of the Activities;
3. The Participant's health and accident insurance shall be primary insurance in the event of Damage;
4. The Participant does not have any condition, disease or injury that would increase the likelihood or magnitude of possible Damage in the course of engaging in the Activities; and
5. I have no reason to believe that the Participant should refrain from engaging in the Activities.
I further agree that should the Participant suffer any injury or condition for any reason which may increase the likelihood or magnitude of possible Damage, I will cause the Participant to refrain from further participation in the Activities until such times as such injury or condition subsides. I accept and acknowledge my responsibility to warn the Participant about the inherent danger of the activities and the importance of observing common safety precautions. I understand and agree that safety precautions do not eliminate the risk involved with the Activities. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual or unnecessary hazard during my presence or participation, I will bring such to the attention of the nearest Power & Grace representative immediately.

I've read the above and agree.
Authorization for Medical Care
Power & Grace, its agents, representatives and employees are hereby authorized, but not required, to:
1. Render first aid emergency treatment of the Participant; and
2. Seek medical help including, but not limited to, transporting the Participant to a health care facility or hospital of Power & Grace's choice; or
3. Call an ambulance.
In the event of an emergency, I by my signature below, hereby authorize Power & Grace, its agents, representatives and employees to admit the Participant to a health care facility or hospital for treatment of the Participant.

I've read the above and agree.
I understand and agree that this Waiver and Release is intended to be as broad and inclusive as permitted by the laws of the State of South Dakota and agree that if any portion is held invalid and unenforceable, the remainder of this Waiver and Release will continue in full force and effect. I further agree that this Waiver and Release shall be determined and settle by arbitration held in Sioux Falls, Minnehaha County, South Dakota, in accordance with the rules of the American Arbitration Association. Any award rendered thereunder shall be final and binding upon all parties and judgment may be entered thereon in any court having jurisdiction. Any advance costs arising from a party's notice to proceed to arbitration shall in the first instance be borne by the party initiating the arbitration, subject to final allocation by the arbitrator. The choice of arbitrator shall be made by the American Arbitration Association and shall be final. Arbitration proceedings may be requested by either party hereto, and either party shall and hereby agrees to, take prompt measures to bring the matter or matters in controversy to arbitration and determination.
I have read this Waiver and Release of Liability Agreement, fully understand its terms, understand that I have given up substantial right by signing it, and sign it freely and voluntarily without any inducement.

I've read the above and agree.
Image Release
I authorize Power & Grace to use any image/video of myself or my child(ren) for any lawful purpose such as publicity, advertising, illustrative purposes and web content.
I've read the above and agree.
The payment due of $255 ($239.44 plus tax) will be charged to the credit card entered when the registration is received. If for some reason you need to cancel your enrollment, you will forfeit a minimum deposit of $25. Any and all requests for cancellations must be submitted by June 25, 2019. After this date, no refunds will be issued.
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: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*