Registration
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Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Friend
Grandparent
Guardian
Mother
Parent
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Emergency Contact Info (Not Contact #1 or #2)
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
USAG membership Number:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
USAG membership Number:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
USAG membership Number:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
USAG membership Number:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
USAG membership Number:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Additional Information:
General Risk & Liability
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I am fully aware of and understand the risk of injury during the sport of gymnastics training, and gymnastics competition despite all reasonable precautions taken for the participant's safety. Those risks include the risk of catastrophic injury, paralysis, and death, and the damage and losses associated with those ricks. I knowingly and willingly assume all those risks as a condition of the student's participation in the programs and activities offered and conducted by Legacy Elite Gymnastics, LLC. For myself and for my heirs and personal representatives and for anyone claiming through me, I hereby waive and release any and all rights and claims for damages for personal injury or other loss that student might have or sustain as a result of or relating to student's participation in any of the programs and activities of Legacy Elite Gymnastics, LLC. The persons released from claims include Legacy Elite Gymnastics, LLC. and the owners, directors, officers, operators, coaches, trainers or staff of Legacy Elite Gymnastics, LLC. As student, or as student's parent or legal guardian, I declare that I am aware of student's experience and capabilities and I understand the nature of the gymnastics programs and activities referred to in the preceding paragraph. I believe student to be in good health, in proper physical condition, and otherwise qualified to participate in those programs and activities. I hereby further release each of the persons designated in the preceding paragraph from any and all claims for loss caused or alleged to have been caused by the negligence of the persons released, or by the negligence of any third party (including emergency and health care personnel), relating to those programs and activities and medical emergency aid rendered in connection therewith. I covenant not to sue any of the persons released in connection with any such claim, and I agree to indemnify and hold them harmless from any cost, expense, attorney's fee, or other loss if student, I, or any other person acting on the student's behalf or otherwise makes any such claim against any of them. All photos or videos taken at and or associated in or with Legacy Elite Gymnastics is property of Legacy Elite and may be used for media or other needs for Legacy Elite Gymnastics. There are no refunds for payments made such as registration fees and tuitions. Accounts on monthly auto charge required to notify before the 20th of the month, by email written notice of cancellation.
I've read the above and agree.
Illness
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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 agree to follow Legacy Elite rules and protocols regarding safety and health regulations and am fully aware that protocols may change. In the event of an "act of God" including but not limited to tornado, hurricane, fire, pandemic illness, etc. tuition is not refundable, prorated, and make up days may not be available.
I've read the above and agree.
Parental Consent
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I, hereby covenant and promise that I am the minor's parent and/or legal guardian, and on behalf of myself and the minor, 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 further understand the risk of exposure to injury and/or infectious diseases, for myself and my child, as a participant, spectator at events, classes or our presence at the facility. I hereby release, discharge, covenant not to sue and agree to defend, indemnify and hold harmless each of the releasees from all liability, claims, demands, losses or damages on the minor's or my account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including, but not limited to injury, negligent rescue operations, and/or exposure to infectious diseases and I further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the above releasees, I will defend, releasees from any litigation indemnify, and hold harmless each of the which such claim. I, hereby covenant and promise that I am the minor's parent and/or legal guardian, and on behalf of myself and the minor, 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 further understand the risk of exposure to injury and/or infectious diseases, for myself and my child, as a participant, spectator at events, classes or our presence at the facility. I hereby release, discharge, covenant not to sue and agree to defend, indemnify and hold harmless each of the releasees from all liability, claims, demands, losses or damages on the minor's or my account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including, but not limited to injury, negligent rescue operations, and/or exposure to infectious diseases and I further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the above releasees, I will defend, releasees from any litigation indemnify, and hold harmless each of the which such claim.
I've read the above and agree.
Agreement
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I hereby release, discharge, and covenant not to sue Legacy Elite Gymnastics, LLC, a limited liability company, Owners, its members, administrators, directors, agents, officers, volunteers, employees, contractors, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of the premises on which the activity takes place, (each considered one of the "RELEASEES" herein) from all liability, claims, demands, losses, damages, on my account caused or alleged to be caused in whole or in party by the negligence of the RELEASEES or otherwise, including negligent rescue operations and further agree that if, despite this release, waiver of liability, and assumption of risk, I or anyone on my behalf, makes a claim against any of the RELEASEES, I will indemnify, defend, and hold harmless each of the RELEASEES from any loss, liability, damage, or cost, which any may incur as the result of such a claim. I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, and I understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. I agree that if any portion of this Agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.
I've read the above and agree.
Participation
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In consideration of participating at Legacy Elite Gymnastics, LLC, a Limited Liability Company, 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 or I am unable to safely perform any activity, I will immediately discontinue participation in the activity. I fully acknowledge, understand, appreciate and agree, 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 the event, the conditions in which the event takes place, or the negligence of the Releasees named below; 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 responsibility for losses, cost, and damages I incur as a result of my participation in the activity.
I've read the above and agree.
Media/Photo release
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For consideration which I acknowledge, I irrevocably grant the Company and the Company's assigns, licensees, successors, and legal representatives the righto photograph, copy, publish, display and use images that have been taken of me in all forms and media including composite or modified representations. I waive the right to inspect or approve the manner in which the images are used and waive the right to inspect any text that is used in connection with the images. Warranty, Indemnity & Release- I warrant that I am of legal age and have the authority to grant the rights under this agreement and agree to indemnify the Company from any claims. I release the Company and the Company's assigns, licensees and successors from any claims that may arise regarding the use of the image, including limitations and any and all claims for libel or invasion of privacy. I hereby warrant that I am of legal age and competent to contract in my own name in so far as the above is concerned, or I hereby certify that I am the parent and/or legal guardian of the minor under the age of legal consent. I hereby consent that any photographs, which have been, or are about to be, taken by the Company, may be used for the purposes set forth in original release above.
I've read the above and agree.
Permission
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I give my child permission to attend the New Year Lockdown at Legacy Elite Gymnastics on Tuesday, December 31, 2024 from 8pm - 8am on Wednesday, January 1, 2025. I understand that my child will remain at the Lockdown for its duration. I also understand that the lockdown is chaperoned by Legacy Elite staff. I acknowledge my child must adhere to all the rules, regulations, and instructions pertaining to the safety and protection of the participants, and that failure to comply could exclude my child from participation in this activity. Should my child not follow the rules for the lockdown, I may be required to pick up my child at any time during the course of the event.
I've read the above and agree.
Items Needed for Lockdown
(Show-Hide Details)
Pillow
Blanket
Pajamas
Oral Hygiene (toothbrush toothpaste)
I've read the above and agree.
Legal Document
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THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT
BEFORE SIGNING. PARENT/GUARDIAN DESIGNATION OF CHAPERONE, CONSENT TO TREATMENT,
WAIVER AND RELEASE FOR LEGACY ELITE GYMNASTICS EVENT OR ACTIVITY
This agreement must be completed by the by Parent(s)/Legal Guardian in order
to participate in the activities associated with this program.
program: LEGACY ELITE GYMNASTICS NEW YEAR LOCKDOWN
PARENT/GUARDIAN, I am the parent/guardian of the named participant and hereby designate
the employees of Legacy Elite to serve as the chaperone for my child (“chaperone”) during the
event. I understand that chaperone has ultimate responsibility for my child during the event and
that chaperone is expected to keep watch over my child/guardian at all times during the event. I
also understand that Legacy Elite Gymnastics is not requiring a background check of chaperone
or otherwise determining the competence or safety of chaperone.
PARENT/GUARDIAN CONSENT TO TREATMENT, WAIVER AND RELEASE I am the
parent/guardian of the participant who is under 18 years of age. I am familiar with the
curriculum and the activities which take place in the named program and hereby give consent for
the participant to participate in the event/program. I understand that participation in the
event/program can include foreseeable and unforeseeable risks and other hazardous activities
inherent in the program, which may expose the participant to illness, injury or death. I state that
Participant is free from any known heart, respiratory or other health problems that could prevent
Participant from safely participating in any of the activities. All relevant allergies and physical
and medical conditions that would or could affect participant's participation in the program are
identified below. I hereby give my express consent in the event of injury for Legacy Elite
Gymnastics to obtain for the participant any necessary emergency aid, anesthesia and / or
operation, if in the opinion of the attending physician, such treatment is necessary. I certify that
participant has medical insurance and otherwise agree to be personally responsible for costs of
any emergency or other medical care that participant receives. I agree to release, waive, covenant
not to sue, and hold harmless Legacy Elite Gymnastics, and all of their officers, employees and
agents (collectively) from the cost of any medical care that participant receives
as a result of participation in the event/program. I further agree to release releasees from any
and all liability, claims, demands, actions and causes of action whatsoever arising out of or
related to any loss, damage, injury, illness, attorney’s fees or harm of any kind or nature to me
arising out of participant’s participation in the event/program. This release extends to any claim
made by parents or guardians or their assigns arising from or in any way connected with the
aforementioned activities. I authorize Legacy Elite Gymnastics to take and use without payment
any photographs, slides, or video of participant as may be needed for public relations,
marketing/advertising in print or on our website, or internal training purposes. I agree that the
site of any lawsuit arising out of or related to participation in the program shall be Illinois and
that this agreement will be governed by and construed in accordance with the laws of the state
of Illinois, without application of any principles of choice of law. I shall pay any attorney fees or
costs incurred by Legacy Elite Gymnastics in enforcing this agreement. If any portion of this
Agreement is held to be invalid by a court of law, then it is agreed and intended that all the
remainder shall, notwithstanding, continue in full force and effect.
I've read the above and agree.
Enter your Full Name:
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Exp Year:
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2025
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2033
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Address Line 1:
Address Line 2:
City:
State:
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AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
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Zip:
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