Registration

Registration

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We are super excited to be hosting your friend's birthday party at Downriver Gymnastics! Please remember to wear comfortable clothing without a hood, skirt, belts, zippers, buttons, snaps, or hooks and make sure your hair is tied back out of your face. We are located at 13777 Eureka Road in Southgate. Please arrive at least five minutes prior to the party start time as all our parties at DG start promptly, and we do not want you to miss out on any of the fun!

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: * Zip: *
	Emergency Contact Info*

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

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

Add New Student #2:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

Add New Student #3:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

Add New Student #4:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

Add New Student #5:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

Additional Information:

Release of Liability

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As parent or legal guardian of the above named persons, I recognize that potentially severe injuries, including permanent paralysis or death can occur in sports or activities involving height or motion, including but not limited to inflatables, gymnastics, tumbling, cheerleading, clinics, camps, private lessons, birthday parties, birthday party guests, open gym, toddler time, and field trips. Being fully aware of these dangers, I voluntarily consent to the aforementioned persons participating in any and all programs at Downriver Gymnastics and I accept all risks associated with that participation. In consideration for allowing my child to use this facility, I, on my own behalf and the behalf of my child and our respective heirs, administrators, executors, and successors, hereby COVENANT NOT TO SUE and FOREVER RELEASE Downriver Gymnastics, its officers, directors, shareholders, employees or other representatives, whether paid or volunteer, from all liability for any and all damages or injuries suffered by my child while under the instruction, supervision, or control of Downriver Gymnastics. I also understand it's the parents responsibility to warn the child about the dangers of gymnastics and injury. The parent should warn the child according to what the parent feels is appropriate. Downriver Gymnastics will only warn the child thru safety signs and our teaching style and progressions. I also understand and give permission for photographs and videos of my child to be used in print or broadcast media as deemed appropriate for the promotion of Downriver Gymnastics.

I've read the above and agree.

Medical Emergency

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I confirm that my child is in good physical and mental health and I have medical insurance on my child and will provide coverage while he/she is enrolled. I fully understand that Downriver Gymnastics staff members are not physicians or medical practitioners of any kind. With the above in mind, I hereby release Downriver Gymnastics staff members to render temporary first aid to my child in the event of any injury or illness, and if deemed necessary by the Downriver Gymnastics staff to seek medical help including calling of an ambulance for said child. Additionally, I hereby agree to individually provide for all medical expenses, which may be incurred by my child as a result of any injury sustained while participating at Downriver Gymnastics.

I've read the above and agree.

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I am aware that adults, 18 years of age and older, will not be allowed on any of the gymnastics equipment, including spring/cheer floors, bars, beams, vaults, trampolines and pits and that parents of party guests will not be allowed in the gym unless my child is under 3 years of age or has special needs.

I've read the above and agree.

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All Participants must wear appropriate attire (NO snaps, zippers, chains, buttons, belts, necklaces, bracelets or dangly earrings.)

I've read the above and agree.

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I am aware that all guests will be asked to remove shoes upon entering the main gym even when just walking through to the back party room.

I've read the above and agree.

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I am aware that if my child is under the age of 3 or has special needs that I or another responsible adult will need to help him or her while in the gym for the party.

I've read the above and agree.

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I am aware the Downriver Gymnastics DOES NOT supply NERF weapons and ammunition. (NERF PARTIES)

I've read the above and agree.

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I understand that the viewing areas for guests of the party are the lobby and party room.

I've read the above and agree.

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I understand that NO food, gum or beverages are permitted outside the provided party area.

I've read the above and agree.

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It is expected that participants respect coaches, gym staff, gym equipment and any other Birthday Party Participant.

I've read the above and agree.

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I understand that there is no smoking with 100 feet of the building, NO EXCEPTIONS.

I've read the above and agree.

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I am aware that no rude, vulgar or offensive/inappropriate behavior will be tolerated by our staff at any time. We will remove anyone who disrupts our family-friendly atmosphere.

I've read the above and agree.

Payment Information

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In the event that I sign my student up for a class in the future, payment is due at the time of registration. I understand that I will be charged the annual registration fee and any applicable class tuition for the month I am submitting my registration (prorated if necessary.) I understand that if I am enrolling my child in a reoccurring monthly program (not a special event) I must agree to the auto debit policy. I also understand that I am giving my permission to Downriver Gymnastics Inc. to charge my credit/debit card on the 25th of each month for the next months class tuition. If payment is declined then I understand that I will receive a $5.00 processing fee. I have until the 28th of the month to resolve my auto debit issue or my child will be dropped from the class due to non-payment, I will be required to pay a $5 re-enrollment fee to put him/her back into a class. I understand that if my child is dropped from class for non-payment they may lose their spot in their class and may not be able to be re-enrolled in the same class. If I choose to withdraw, I understand that I must SUBMIT A WRITTEN Request to Withdraw form to Downriver Gymnastics PRIOR to the 24th of the month preceding the month I am dropping (for example, you must submit your request to withdraw by August 24th if you wish to withdraw from September classes.) This form can be obtained in the Downriver Gymnastics office or at our website, www.downrivergymnastics.com, under the Contact Us page. When this form is submitted in person to the office staff, a receipt will be returned to me for my records. I understand that if my submission is received after the 24th of the month, I will be charged for the entire month. NO REFUNDS. Downriver Gymnastics will not provide a refund but will put a credit on your account to be used for any class, clinic, or pro shop purchases. I will be responsible for all costs incurred for collection of any delinquent payments, including but not limited to collection/attorney fees/court costs. Fees for other products and/or services shall be paid for at the time of purchase and/or registration. Downriver Gymnastics will only allow make-up classes in Open Gym, Clinics, or Drop-In Tumbling. This includes missed classes due to holiday, vacation, illness, weather, or any other reason. Students must be currently enrolled in classes to take advantage of a make up class. A $25.00 late fee will be applied to any outstanding balances on the 1st of each month. There is a $25.00 returned check charge for any checks returned by the bank.

We are a year-round program with a monthly tuition based on an average of four classes per month with all holidays and scheduled closings taken into account. If there are five classes in a month, we do not increase tuition. If there are three, we do not give credit.

I've read the above and agree.

Signature Text

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I certify that I am the parent or legal guardian of the above mentioned students. I have read and understood the foregoing release.

I've read the above and agree.

Enter your Full Name:

*

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