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Scarlet Knights Gymnastics - FALL HIGH PERFORMANCE CLINIC - Saturday, November 13th, 2021 *Recommended for USAG Levels 8-10*

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Family/Parent Information

	First Name:*	Last Name: *
	Relationship*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Other Emergency Contact:*

Students entered below will be added to your family's account

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Health Insurance Company:*
Doctor's Name & Phone Number:*
Club Gym/Gymnastics School:*
Child(ren)'s Current Level(s) & Competitive League (USAG, USAIGC, XCEL, JOGA, etc.):*
Does your gymnast(s) have any current/chronic injuries that we need to be aware of? If so, please email us a doctor's note (if applicable) with any restrictions or directions in regards to training.
Permission to Leave: Please list all Adults that your child are allowed to leave with: all family members, teammate's parents, coaches, etc. A Photo ID must be provided at check out for dismissal*
T-Shirt Size CXS-AXL (Please list Name & Size for Multiple Children):*
Does your child have any food allergies or dietary restrictions? If so, please specify.*

Additional Information:

Assumption of Risk & Consent Waiver

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All precautions will be taken to prevent accidents. Simple First-Aid will be administered to all minor injuries. Parents and/or paramedics, ambulance or doctor may be called when necessary. It is hereby agreed that I, my child(ren), my grandchildren, my heirs and executors, waive and release all rights and claims for damages that I may have at any time at Scarlet Knights Gymnastics Academy (SKGA, LLC) and Rutgers University. I understand that participation in gymnastics and use of its equipment may cause injury (both minor and severe), paralysis, and even death. In such a circumstance, I do not hold Rutgers University, or Scarlet Knights Gymnastics Academy or its director, staff, and coaches responsible for any injury or accident anywhere on site (anywhere inside or outside the facility , recreation center, or traveling to or at any outside events associated with SKGA). By signing below, I agree that all the risks involved in respect to such a program are fully understood . This release is valid at all terms or months my family and I are enrolled or participating in any activities/camps/clinics. I hereby fully release and forever discharge Scarlet Knights Gymnastics Academy (SKGA) and any of their officers, directors, employees or representatives from any and all claims, actions, lawsuits or damages of any type for any claims arising from participation in this program.
As the parent or legal guardian of the child enrolled, I hereby give my full consent and approval for my child to participate. I understand that there are certain risks of injury inherent in the practice and play of this sport, as well as in traveling and other related activities incidental to my child’s participation, and I am willing to assume these risks on behalf of my child. I hereby certify that my child is fully capable of participating in the designated sport and has no physical or mental disabilities or infirmities that would restrict full and safe participation in these activities. If my child has any existing injuries, conditions, illnesses, and other restrictions that should limit participation, I will indicate them upon registration.

I've read the above and agree.

Payment Agreement

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I hereby authorize Scarlet Knights Gymnastics Academy (SKGA, LLC) or its authorized credit/debit card transaction agent(s), to bill my credit/debit card account indicated on my registration form, and or added to my online customer account, for payment of all services, tuition, registration fees, party/event fees, and any other charges associated with my family’s enrollment in classes, practices, and all activities at SKGA (Fees are subject to change). I agree that I am responsible for the full payment of all charges for each session/event my child(ren) and family are enrolled, from the date of registration, to the end date of session/event, regardless of attendance. I also understand that I must have credit or debit card on file to register, but may still make payments by cash, credit/debit or check. In the event that I do not submit or initiate payment on or by the due date (including first class for recreational students, 15th of each month for team/pre-team participants, or specified dates for camp or other events) I further authorize SKGA to bill by debit/credit card account on file for the balance owed, plus any late fees and processing charges. In the event I am granted a special payment plan, I will adhere to all due dates, and will be charged regardless of attendance. I also understand that there are no refunds given for any payments made for past, present, or future services, classes, parties, camps, or other of services at SKGA.
It is my responsibility to inform SKGA of any changes to my credit/debit card or any accounts used for payments, including, but not limited to, card expiration, name change, loss or theft of card, etc. In the event my credit or debit card is declined, or my check is returned for any reason, I understand I will be responsible for the full payment as well as any late charges or service charges related. I have read this agreement and all SKGA policies and understand that I will be held responsible for its terms and conditions of service.
It is my responsibility to inform SKGA of any changes to my credit/debit card or any accounts used for payments, including, but not limited to, card expiration, name change, loss or theft of card, etc. In the event my credit or debit card is declined, or my check is returned for any reason, I understand I will be responsible for the full payment as well as any late charges or service charges related. I have read this agreement and all SKGA policies and understand that I will be held responsible for its terms and conditions of service.

I've read the above and agree.

Payment & Cancellation Policies

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I've read the above and agree.

Consent & Release

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Rules & Policies

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I've read the above and agree.

Waiver for Communicable Disease

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WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19
In consideration of being allowed to participate on behalf of the Scarlet Knights Gymnastics Academy program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:
1. Participation and entry into facility includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for myself, my family, and my child's participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Scarlet Knights Gymnastics Academy (SKGA), the YMCA at the Piscataway Community Center, and their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law; and,
5. I understand that coaches may/will need be in physical contact when spotting skills, training and other general coaching duties.
6. I understand Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing as a mean to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in SKGA programs or accessing SKGA, Rutgers, or YMCA facilities could increase the risk of contracting COVID-19. SKGA in no way warrants that COVID-19 infection will not occur through participation in SKGA programs or the facility.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I ACKNOWLEDGE THAT I HAVE RECEIVED THE GUIDELINES AND AGREE TO ABIDE BY THEM. I UNDERSTAND THAT THE GUIDELINES MAY CHANGE AT ANY TIME BASED ON OFFICIAL RECOMMENDATION.

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to myself, my family, and my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, my family, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child's/ward's presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
By enrolling in our sessions, our families agree to review and follow all rules and policies stated on our website, and those emailed to them. In addition, by registering, they also confirm that they have been following all re

I've read the above and agree.

Informed Consent & Transportation Waiver

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I (parent) allow my child(ren) to participate in all activities involved with SKGA’s Fall Clinic. The clinic will include gymnastics activity, as well as campus tours, and special educational sessions. I recognize and acknowledge the following: By signing below, I give my consent for the person identified above (my child) to be transported by the staff of Rutgers Gymnastics & Scarlet Knights Gymnastics Academy (SKGA, LLC) and will assume all liability for their participation in this activity and any injury that may happen in the duration of the transport, at the site or on other Rutgers University campuses of the event. I authorize Rutgers Gymnastics and SKGA to procure and provide transport solely for my child / children. I will not hold Rutgers Gymnastics, SKGA or Rutgers, the State University of NJ , its officers, employees, members, volunteers, or anyone acting on its behalf, responsible or liable for injury occurring to the named person in the course of such activities or in the duration of travel. I also authorize Rutgers Gymnastics and SKGA to transport and to obtain, through a physician of its own choice, any emergency medical care that may become reasonably necessary for the person in the course of such activities or the duration of travel, and agree to accept the cost of the treatment by medical personnel or facility. I understand that transportation entails risk of bodily injury or property damage I certify that my child is physically able to participate and know of no disability, which would prevent their participation That there are risks of bodily injury or property damage caused or resulting from slips, trips, or falls While on campus, I am bound by all rules and regulations of SKGA, University, State and Federal laws. I understand that while on campus I will subject to interactions with minors as a part of the Rutgers University community whether directly or indirectly. Notwithstanding these risks, I for myself, my heirs and assigns do waive, release and discharge both Scarlet Knights Gymnastics Academy (SKGA, LLC), Rutgers Gymnastics, and Rutgers, the State University of New Jersey, it governors, trustees, officers, employees, and agents from, and against, all claims for bodily injury, death or property damage, arising in any manner out of my presence or activities in connection with this trip. Furthermore, I acknowledge that the risks outlined above are not intended to be all inclusive and voluntarily accepts all risks known or unknown.

I've read the above and agree.

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