Registration

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Winter Ninja Challenge! Combine agility, speed, strength, momentum, precision and balance in order to navigate and overcome obstacles in various environments through jumping, swinging, climbing, balancing, and running. Test your athletic ability!

Event:

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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 (Different from primary)*

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

Additional Information:

Photo/Social Media Policy

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Code of Conduct

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Safety is our number one priority, therefore it is imperative that all kids listen to the coach and/or other team members (staff/directors/owners) while in and outside of the facility and gym at all times. Children are required to adhere to all gym safety rules, treat their coaches as well as fellow gymnasts/ninjas with respect. This means no pushing, hitting, fighting , bullying, teasing, tackling, foul language, rolling of the eyes in a defiant response to the coach/team member, backtalk, intentionally damaging equipment and/or matting, and/or intentionally cutting in line. If a child chooses not to listen to, respect or follow the direction of the coach and other staff members while in the facility, they will be give a "warning". If this behavior continues, they will then be given a "time out". Then if the behavior continues the athlete will be dismissed from the class and possibly expelled from the program. There are NO REFUNDS if a child is dismissed from the program for not listening to any of these rules and/or being a danger to themselves or others in class. When a child is a risk to themselves and/or others, a child can be dismissed from the class and expelled from the program immediately. Your child's behavior has an impact on the overall quality of the class and we do not take lightly to children that choose not to listen to or respect their coaches , staff members and/or fellow classmates.

CLOTHING AND ATTIRE:

Clothing should be nonrestrictive, form fitting, free of zippers, buttons, snaps and other decoration that can catch on equipment. Necklaces, earrings and other jewelry should not be worn in the gym. Attire for girls: leotards, unitards, one piece bathing suits, shorts and a t-shirt (tucked in) are all acceptable. Attire for boys: t-shirts and shorts or sweat pants are acceptable. All gymnasts are required to be bare footed and long hair must be tied back or pulled away from the face prior to class. All ninja participants are required to wear sneakers that can be tightened.

Hair should be pulled back into a pony-tail or braids so that the hair does not create a distraction.

Every child is required to bring a water bottle filled with water. Water fountains will not be in use.

Parents are not allowed in the gym unless they are involved in a parent child class. Siblings or other children are not permitted in the gym unless they are enrolled in a class. Older siblings are not allowed on the floor during parent-child classes. Please use the observation area provided.

All viewing must be done from the observation area.

Parents, please keep children not participating in class with you and under your supervision at all times.

If you leave the gym during class, please return on time and come into the lobby to pick up your child. Gymnasts are not allowed to wait outside for rides. If you plan to leave, please inform the front desk and write a note with your contact info, in case there is an emergency.

Gymnasts must wait in the lobby or balcony area until the instructor calls the class to the gym floor. No one is allowed on the floor without an instructor.

If you are in the lobby, talking on the phone or listening to music, videos or anything with audio is prohibiting without headphones. This rings true for kids in the waiting room as well.

There is no consumption of food allow

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Authorization of Medical Treatment

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Authorization for Medical Treatment for Minor Participant of Dominique Dawes Gymnastics Academy

In consideration for permission to participate in activities at and to access the premises and facilities of Dominique Dawes Gymnastics Academy, 22530 Gateway Center Drive, Suite 700, Clarksburg, Maryland 20871 ("Dominique Dawes Gymnastics"), I, the parent/guardian (hereinafter, "Participant"), hereby certify that, to the best of my knowledge and belief, Participant has no known medical problems or conditions that would prevent him/her from participating in the programs or activities at Dominique Dawes Gymnastics. I hereby authorize Dominique Dawes Gymnastics and/or its members, managers, officers employees, coaches, teachers, authorized agents or certified emergency trained personnel, to furnish emergency medical services and/or secure emergency medical treatment, including but not limited to transport and admission to a hospital or other health care facility, for Participant as deemed necessary. I acknowledge and understand that Dominique Dawes Gymnastics is not financially responsible for the expenses of medical treatment, emergency care or transportation and does not provide health or accident insurance coverage to participants. I agree to be financially responsible for the expenses of any such emergency medical treatment/services or transportation and agree to pay for all medical treatments, procedures, care, and transportation individually, or through my medical insurance program. I hereby waive, release, discharge, and agree to hold harmless Dominique Dawes Gymnastics from and against any and all liability, loss, damage, and claims of any nature which in any manner arise from or relate to such emergency medical services or treatment.

I understand that my child's participation in the above-referenced program or activities is performed under this specific understanding. I have read and understand the foregoing and voluntarily sign this Authorization for Medical Treatment with full knowledge of its contents and significance.

*This form is required by Dominique Dawes Gymnastics for all gymnastics, ninja and summer camp participants attending the Dominique Dawes Gymnastics location and should be completed in addition to the Waiver & Release of Liability Agreement.

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Liability Waiver

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DISCLAIMER: KQLD, LLC t/a Dominique Dawes Gymnastics Academy ("Dominique Dawes Gymnastics") is not responsible for any injury (or loss of property) to any person while practicing, training, taking class, competing, participating in open gym, special events, demonstrations or shows, or in any other way involved in gymnastics, tumbling, trampoline, or ninja training (flips, rolls, jumps, kicks) and strength and agility training in general (collectively the "Activity") at Dominique Dawes Gymnastics for any reason whatsoever, including ordinary negligence on the part of Dominique Dawes Gymnastics, its members, managers, agents, or employees, teachers, coaches, administrators, directors, agents, officers, volunteers, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place (hereinafter each a "Releasee" and collectively the "Releasees"). Additionally, the novel coronavirus, Coronavirus Disease 2019 (COVID-19), has been declared a worldwide pandemic by the World Health Organization and COVID-19 is highly contagious. As a result, federal, state, and local governments and federal and state health agencies have recommended social distancing and have, in many locations, prohibited the congregation of groups of people. Dominique Dawes Gymnastics, where possible, has and will continue to implement policies intended to reduce the potential for the spread of COVID-19, but cannot guarantee that any person will not become infected with COVID-19 as a result of attending or participating in any Activity at Dominique Dawes Gymnastics.

CONSENT: I consent to my/minor's participation in the Activity and acknowledge that I fully understand my/minor's participation may involve risk of serious bodily injury, permanent disability, paralysis, illness, or death, including losses which may result not only from my/minor's own actions, inactions or negligence, but also from the actions, inactions, or negligence of others, the condition of the facilities, equipment, or areas where the Activity is being conducted, and/or the rules of play of this type of Activity. I understand that if I have any risk concerns, I shall discuss them completely with the staff before I sign this agreement and before my/minor's participation in the Activity begins. Further, by registering my/minor's participation for the Activity, and utilizing the services, facilities or premises at Dominique Dawes Gymnastics, I affirm that I understand and voluntarily accept any increased risk to me, my family or members of my household of contracting COVID-19. I acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that accordingly, U.S. Centers for Disease Control & Prevention guidance is regularly modified and updated, and I accept full responsibility for familiarizing myself with the most recent updates, as well as the changing conditions in our community, and all state and local orders.

ASSUMPTION OF RISK: Knowing and understanding the risks involved with participation in the Activity, including, but not limited to, those associated with the spread of COVID-19, I hereby voluntarily and willingly assume full and complete responsibility for all losses and damages, including injury, illness, and death, resulting from my/minor's participation in the Activity, including transportation to and from the Activity. I agree I am financially responsible for any losses and damages resulting from my/minor's participation in the Activity.

ATTESTATION: I affirmatively represent and attest that neither I, my minor, nor anyone in my household:

* is experiencing any symptom related to COVID-19 including, but are not limited to the following: cough, shortness of breath or difficulty breathing, chills, fever in excess of 100 degrees, muscle pain / body aches, sore throat, new loss of taste or smell, nausea, vomiting, and diarrhea. Symptoms may appear 2-14 days after e

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No Refund Policy

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Spot Tv Release

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