Registration
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Family Information
First Name:
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Last Name:
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Type
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Emergency Contact Info (Not Contact #1 or #2)
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
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Last Name:
*
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:
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Last Name:
*
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:
*
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:
*
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:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Additional Information:
Assumption of Risk
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I acknowledge that there are INHERENT RISKS in visiting and/or participating at or for East Coast Gymnastics & Cheer, LLC:
I am aware that activities involving height, motion or inversion including, but not limited to gymnastics, tumbling, trampoline, cheerleading, ninja, parkour, martial arts, dance and ball sports pose a risk of injury. I understand that ALL programs and related activities at East Coast Gymnastics & Cheer LLC, always involve certain risks, including but not limited to, death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury to virtually all bones, joints, muscles, and internal organs, and the mats, pits, and other safety equipment and apparatus provided for my and/or my child(ren)'s protection including the active participation of a coach or teacher who will spot or assist in the performance of certain skills, may be inadequate to prevent serious injury. The risk of harm may be limited by all of the safety equipment and trained coaches, but never eliminated.
I understand that participation in gymnastics, including moving from event to event, conditioning, stretching and other activities which may leave me vulnerable to the reckless actions of their participants who may not have complete control over their actions or who may not see other students in the gym. I am voluntarily participating in this activity with knowledge of the risks involved and hereby agree to accept any and all inherent risks of property damage, personal injury, or death.
I further acknowledge, understand, appreciate and agree that my participation may result in 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. 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 my participation and exposure.
I acknowledge that the aforementioned risks may result from the actions, omissions, or negligence of myself or others, including, but not limited to, East Coast Gymnastics & Cheer employees, volunteers, officers, board members, owners, agents as well as participants and visitors and
I HERBY VOLUNTARILY AGREE TO ASSUME ALL RISKS AND ACCEPT SOLE RESPONSIBILITY
for any injury, illness, disfigurement, disability or death to my child(ren) or myself in connection with my child(ren)’s or my visiting or participation at or for East Coast Gymnastics & Cheer, LLC.
I've read the above and agree.
Release of Liability
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DISCLAIMER: EAST COAST GYMNASTICS & CHEER, LLC. IS NOT RESPONSIBLE FOR ANY INJURY (OR LOSS OF PROPERTY)
TO ANY PERSON WHILE VISITING AND/OR PARTICIPATING IN ANY PROGRAM OFFERED AT EAST COAST GYMNASTICS & CHEER, LLC. FOR ANY REASON WHATSOEVER, INCLUDING ORDINARY NEGLIGENCE ON THE PART OF EAST COAST GYMNASTICS & CHEER, LLC., ITS OWNERS, OFFICERS, AGENTS, OR EMPLOYEES.
In consideration of my participation, I hereby release and covenant not-to-sue East Coast Gymnastics & Cheer, LLC, the East Coast Gymnastics & Cheer Booster Club, and any of their employees, teachers, coaches, or agents, from any and all present and future claims resulting from ordinary negligence on the part of East Coast Gymnastics & Cheer, LLC, or others listed for property damage, personal injury, or wrongful death, arising as a result of my engaging in or participation in gymnastics, ninja/parkour class, cheerleading, tumbling, trampoline, or any other program offered at East Coast Gymnastics & Cheer, LLC; including moving from event to event, conditioning, stretching and other activities, or any other activities or any activities incidental thereto, wherever, whenever, or however the same may occur.
I hereby voluntarily waive any and all claims resulting from ordinary negligence, both present and future that may be made by family estate heirs, assigns, or me.
I further agree to indemnify and hold harmless East Coast Gymnastics & Cheer, LLC and all others listed for any and all claims arising as a result of my engaging in or receiving instruction in East Coast Gymnastics & Cheer, LLC. activities or any activities incidental thereto, whenever, wherever, or however the same may occur.
I understand that this waiver in intended to be as broad and as inclusive as permitted by the laws of the state of Virginia and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be within the state of Virginia. I affirm that I am of legal age and am freely signing this agreement. I have read this form and fully understand that by signing this form, I am giving up legal rights and or remedies which may be available to me for the ordinary negligence of East Coast Gymnastics & Cheer, LLC or any person listed above.
I've read the above and agree.
Photo/Video Release
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By creating an account through this parent portal and agreeing to this policy, I hereby grant and authorize East Coast Gymnastics & Cheer LLC the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures or videos taken of me or my minor child/ren by East Coast Gymnastics & Cheer LLC to be used in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits, and submissions to journalists, websites, social networking sites and other print and digital communications, without payment or any other consideration.
This authorization extends to all languages, media, formats and markets now known or hereafter devised. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing.
I understand and agree that these materials shall become the property of East Coast Gymnastics & Cheer LLC and will not be returned.
I hereby hold harmless, and release East Coast Gymnastics & Cheer LLC from all liability, petitions, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.
I've read the above and agree.
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