Registration
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Event:
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Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Type
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Zip:
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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:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Disabilites (leave blank if None):
Allergies (leave blank if None):
Medications (leave blank if None):
Primary Doctor:
Add New Student #2:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Disabilites (leave blank if None):
Allergies (leave blank if None):
Medications (leave blank if None):
Primary Doctor:
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Disabilites (leave blank if None):
Allergies (leave blank if None):
Medications (leave blank if None):
Primary Doctor:
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Disabilites (leave blank if None):
Allergies (leave blank if None):
Medications (leave blank if None):
Primary Doctor:
Add New Student #5:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Disabilites (leave blank if None):
Allergies (leave blank if None):
Medications (leave blank if None):
Primary Doctor:
Questions/Options:
What is your child's age:
*
Is your athlete trying out to be a Flyer? Yes or No If YES, you must also sign up for the flyer tryout on May 10th
*
Yes
No
What type of team are you trying out for? - Elite , Prep , or Novice
*
Additional Information:
Element Waiver
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In consideration of participating in activities held at Harper Enterprises NC LLC dba Element Gymnastics and Sports Center, I represent that I understand the nature of this activity and that I am qualified, in good health, and in proper physical condition to participate in such activity. I acknowledge that if I believe event conditions, are unsafe, I will immediately discontinue participation in the activity. I fully understand that this activity involves risks of serious bodily injury, including permanent disability, paralysis, and death, which may be caused by my own actions, or inactions, those of others participating in he event the conditions in which the event takes place, or the negligence of the "releases" named above, and that there may be other risks either not known to me or not readily foreseeable at this time, and I fully accept and assume all such risks and all the responsibility for losses, cost and damages I incur as a result of my participation in the activity. I hereby release, discharge and covenant not to sue Harper Enterprises NC LLC, Element Gymnastics and Sports Center, it's respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the activity takes place (each considered one of the "releasees" herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in the whole or in part by the negligence of the "releasees" or otherwise including negligent rescue operations and future agree that if despite this release, waiver of liability, and assumptions of risk, I or anyone on my behalf makes a claim against any of the the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage or cost, which any may incur as the result of such claim. I have read the Release and waiver of liability, assumption of risk, and indemnity agreement, and understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance o any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect. Parental consent and I the minor's parent and / or legal guardian, understand the nature of the above referenced activities and the Minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasee's from any litigation expenses, attorney fees, loss liability, damage or cost any Releasee many incur as the result of any such claim. I authorize Element Gymnastics and Sports Center to utilize video tape, audio, or photographic materials of myself or dependent children, for the purpose of promotional materials for Element Gymnastics and Sports Center programs and services. This includes printed advertising material which may be posted on the Element Gymnastics and Sports Center website. I further understand there is a no refund policy.
***There is a $25 charge for returned checks. A 30 DAY written notice is required when discontinuing.
I've read the above and agree.
Rock Solid Waiver
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Waiver and Release of Liability Form
In exchange for and consideration of being permitted to participate in the physical skill demonstration hosted by ROCK SOLID WARRIOR LLC (doing business as MOBILE NINJA WARRIOR) in cooperation with GYMNASTICS COUNTS, I, the undersigned Participant, HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS INDOOR PHYSICAL SKILL EVENT AND OBSTACLE COURSE, including by way of example and not limitation, any risks that may arise from negligence or carelessness on part of the person or entities being released, from dangerous or defective equipment or property owned, maintained, rented, or controlled by them or because of their possible liability without fault.
I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised not to participate by a qualified medical professional. I certify that there are no health-related reasons or problems, which preclude my participation in this activity.
I acknowledge that this Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.
In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: ROCK SOLID WARRIOR LLC, Kenneth W. Auer, Caleb G. Auer and their families, employees or volunteers of ROCK SOLID WARRIOR LLC as well as GYMNASTICS COUNTS, its officers, agents and employees or volunteers and The LeConte Center of Pigeon Forge, The City of Pigeon Forge, Its Officers, Agents and Employees.
INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons
I acknowledge that ROCK SOLID WARRIOR LLC, Kenneth W. Auer, Caleb G. Auer and their families, employees or volunteers of ROCK SOLID WARRIOR LLC, and the other above named entities are NOT responsible for errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.
I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include but are not limited to, those caused by terrain, temperature, weather, condition of participants, equipment, defect in equipment, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, sponsors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers. I hereby agree to bring no claim whatsoever against the released parties on account of any injury or damage I may sustain while participating or attending this activity.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.
I hereby grant ROCK SOLID WARRIOR LLC and GYMNASTICS COUNTS permission to use my likeness in a photograph, video, or other digital media ("photo") taken during this activity in any and all of its publications, including web-based publications, without payment or other consideration.
I understand and agree that all photos will become the property of ROCK SOLID WARRIOR LLC or GYMNASTICS COUNTS and will not be returned.
I hereby irrevocably authorize ROCK SOLID WARRIOR LLC to edit, alter, copy, exhibit, publish
I've read the above and agree.
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