Consent for Emergency Medical Treatment
AS THE PARENT OR AUTHORIZED REPRESENTATIVE, I HEREBY GIVE CONSENT TO Girls Inc. of Greater Santa Barbara TO OBTAIN ALL EMERGENCY MEDICAL OR DENTAL CARE PRESCRIBED BY A DULY LICENSED PHYSICIAN (M.D.) OSTEOPATH (D.O.) OR DENTIST (D.D.S.) FOR MY CHILD. THIS CARE MAY BE GIVEN UNDER WHATEVER CONDITIONS ARE NECESSARY TO PRESERVE THE LIFE, LIMB OR WELL BEING OF THE CHILD.
Release of Liability and Waiver of Liability
Parent/Guardian: Please read the following Release / Waiver of Liability fully and be certain you understand it before signing.
Assumption of Full Responsibility for all Risks of Bodily Injury, Death, or Damages: As a parent or legal guardian, I hereby authorize and consent to their participation in the programs offered by Girls Inc. of Greater Santa Barbara ("GIGSB") and I represent that they are medically able to participate in those events without risk of harm to themselves or others. I understand that participation in activities at GIGSB, including but not limited to its after-school programs, classes, field trips, sporting events, surfing, cooking, and other athletic events and activities may result in unavoidable injuries including, but not limited to, muscle or other soft tissue strains, sprains and tears, broken bones, and severe injuries such as paralysis or even death, and I voluntarily assume the risk of injury associated with those events.
Girls Inc. of Greater Santa Barbara Gymnastics Only: I authorize and consent participating in gymnastics activities held by GIGSB and I represent that they are medically able to participate in those activities without risk of harm to themselves or others. I acknowledge that various factors and causes, known and unknown, associated with Gymnastics could cause injuries, which include, but are not limited to, the height and positioning of the equipment and the body during certain movements, rotation of the body, and movement of the body, in a unique environment. I am fully aware of the inherent risks involved in gymnastics, trampoline, dance, and all other physical activities offered by GIGSB Gymnastics and I am aware of the possibility of injury from participating in the aforementioned activities, and I voluntarily assume the risk of injury posed by such activities.
Notification: In case of injury, illness, or any situation that could require medical attention during or by reason of a GIGSB program or excursion, it is understood that a conscientious effort will be made to notify the child's parent or guardian before medical attention or other necessary action is taken. If a parent or guardian cannot be located in a timely manner, I understand that the expense of this service will be accepted by the child's parent or guardian on record. In the event that such care or medical treatment is deemed by GIGSB to be necessary, I agree to release GIGSB from any liability in connection with such care or medical treatment.
Waiver of Liability: In consideration for allowing my child to participate in activities offered by GIGSB. I, my heirs and assigns, next of kin, and all others acting on my and my child's behalf agree to waive any and all rights, claims, damages, actions, causes of action or suits of any kind or nature whatsoever which I or my child has or may hereafter have against GIGSB or any agent, employee, representative or other acting on their behalf and to indemnify, defend and hold harmless GIGSB or any agent, representative or other acting on their behalf for any injuries suffered as a result of engaging in those activities offered by GIGSB. I hereby release GIGSB and any agent, employee, representative or other acting on their behalf or at their direction from liability for ordinary negligent conduct that may occur in the future.
Should any part or parts of this agreement be held null and void, the balance of the agreement shall remain valid and maintain its full force and effect. This acknowledgement of risk and WAIVER OF LIABILITY has been read by me and understood completely and signed voluntarily. I am 18 years of age or older.
COVID-19: Assumption of Risk / Waiver of Liability
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. Girls Inc. of Greater Santa Barbara ("GIGSB") has put in place preventative measures to reduce the spread of COVID-19; however, GIGSB cannot guarantee that you and/or your child will not become infected with COVID-19. Further, participation in activities held by or associated with GIGSB could increase your or your child's risk of contracting COVID-19.
READ CAREFULLY BEFORE SIGNING
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I and/or my child may be exposed to or infected by COVID-19 by participation in events held by or associated with GIGSB; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, GIGSB's employees, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself and/or to my child (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation in events held by or associated with GIGSB ("Claims"). On my behalf and/or that of my child, I hereby release, covenant not to sue, discharge, and hold harmless_GIGSB, its employees, volunteers, contract workers, agents, and representatives ("Releasees"), of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of_GIGSB, its employees, volunteers, contract workers, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation held by or associated with GIGSB.
I represent that I have adequate insurance to cover any injury or illness I and/or my child may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or illness myself. I further represent that I and/or my child have no medical or physical condition which could interfere with the safe participation in this activity, and I am willing to assume - and bear the costs of - all risks that may be created, directly or indirectly, by any such condition.
Any legal proceeding that is brought to interpret or enforce the rights and obligations covered by this Agreement will be brought in the State of California, Santa Barbara County, and governed by the laws of the State of California.. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
I have had sufficient time to read this entire document and have had the opportunity to consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is reasonable. I have read and understood this document and I agree to be bound by its terms.
If I have signed a separate general waiver of liability connected to my participation in events held by or associated with GIGSB, I agree that the terms of that waiver are wholly incorporated into this document and that the terms of this document are incorporated into the separate general waiver.
I agree that I and/or my child will comply with all health and safety rules and guidelines imposed by GIGSB or by any state, local or federal governmental entity, and will practice safe social distancing and clean hygiene during my participation at events held by or associated with GIGSB or while on GIGSB premises.
I am the legal parent or guardian of the minor participant and I am authorized to enter into this Agreement on their behalf. In consideration of the minor participating being permitted to participate in activities held by or associated with GIGSB, I further agree to indemnify and hold harmless Releases from any claims alleging negligence which are brought by or on behalf of minor participant or are in any way connected with such participation by minor participant.
Media Consent/Release for Minor
Parent/Guardian: This is a release of Legal Rights. Please read it carefully and be certain you understand it before signing below. A separate media release must be signed for each child within the same family.
I am the legal parent/guardian of the registered child. I hereby give unrestricted permission for My Child to be photographed, videotaped, digitally recorded, audio taped, and/or interviewed by Girls Inc. of Greater Santa Barbara ("GIGSB") or its representatives. I understand and agree that the photographs and/or video containing the image, likeness and/or voice of My Child, in whole or in part, may be used in the production of instructional and/or promotional materials produced by or on behalf of GIGSB, and may be shared with third parties, and that such materials may be distributed or broadcast to the public and displayed publicly. I also consent to the use of my child's name, likeness or photograph, voice, or creative works on the internet or on other electronic/digital media or print media.
I hereby grant GIGSB, and its agents the absolute right and permission to use My Child's image/likeness/voice and/or photographic portraits, pictures, digital images, stories, quotes, audio, or video of My Child, or reproductions thereof or otherwise for any lawful purpose, whatsoever, including but not limited to use in any GIGSB promotion through publication, website, social media, video, interview, event and/or advertising. I hereby waive any right that I may have to inspect and/or approve the finished project or the copy that may be used in connection therewith, wherein My Child's likeness appears, or the use to which it may be applied.
I also understand that my permission to use the photographs, likeness, audio or video is for an unlimited duration. I also agree that no money or other consideration, including expense reimbursement, will be due to me or My Child, or our heirs, at any time because of My Child's participation in any of the above or the use of My Child's name, likeness, photograph, voice or creative work.
As My Child's parent or legal guardian, I agree to release and hold harmless GIGSB, its members, directors, agents, officers, contractors, volunteers and employees from and against any and all claims, demands, actions, complaints, suits or other forms of liability that arise out of or by reason of the use of My Child's name, photograph, or likeness, voice, or creative work on television, radio, motion pictures, social media, internet, or any other electronic/digital media or print media.
I understand that I will need to notify GIGSB in writing if any changes to my situation occur that will impact this media release. I understand that any changes in consent will apply from the date of receipt of that written notification moving forward and cannot be applied retroactively to previously created photographs, stories, quotes and the like, and/or any promotional materials.
I am at least 18 years of age and am fully competent to sign this release.
IF YOU WOULD LIKE TO DECLINE THE PHOTO/MEDIA RELEASE, PLEASE MAKE NOTE IN THE REGISTRATION. THERE IS AN OPTION TO SELECT YES OR NO.
Acknowledgement/Consent Live Video Streaming
Effective July 1, 2020, Girls Inc. of Greater Santa Barbara (GIGSB) has established new spectator viewing protocols and procedures as a result of the COVID-19 pandemic. As part of these measures, GIGSB will live stream all gymnastics lessons, classes, and practice in the Girls Inc. gym via Zoom.
These new procedures allow GIGSB to:
1) Comply with USA Gymnastics regulations requiring the ability for parents and guardians to maintain visual contact with their child at all times and
2) Ensure social distance is maintained inside the gym according to the Santa Barbara County Public Health Department guidelines that restrict the number of people in the gym.
Access to Zoom will be restricted to parents and/or guardians of children in each class and participants will be monitored by Girls Inc staff at all times. No content will be recorded on Zoom. I am the legal parent/guardian of the registered child. I hereby acknowledge that Girls Inc. will be live streaming all gymnastics programming until further notice.
I understand that I will need to notify GIGSB in writing if any changes to my situation occur that will impact this acknowledgement and consent.
I understand that any changes in consent will apply from the date of receipt of that written notification moving forward and cannot be applied retroactively.
I am at least 18 years of age and am fully competent to sign this Acknowledgement and Consent.
Code of Conduct
Equipment: Use of equipment or play in the pit is not permitted without the supervision of a Girls Inc. Gymnastics Instructor.
Tardy Policy: Children who are more than 10 minutes late will not be allowed to participate in class for that day due to safety and liability reasons resulting from missing warm-up time. For gymnasts who are less than ten minutes late, but are continually late, they will not be allowed to participate in class upon a fourth tardy, as late arrivals are very disruptive for the instructors and the other gymnasts.
Before Class: Children are to remove their shoes and socks and wait in the cubby area until the Gymnastics Instructor indicates it is the start of class.
During Class: All children are expected to listen to their instructor when they are talking. This ensures that all children are able to clearly hear the directions provided. Children are expected to participate in the class for the entire class period. If a child needs to use the restroom, it is very important they let the instructor know, at which time the child will be excused to use the restroom.
At All Times: Girls Inc. asks that all gymnasts follow our four agreements which are for all participants to be respectful, be responsible, stay safe, and have fun. Instructors will review these agreements with gymnasts at the start of each class. The instructors are here to help your child be the VERY BEST they can be.
Stretching and Conditioning: Children are expected to stretch and condition as directed by their instructor. Stretching and conditioning are vital to a gymnast's progress and helps prevent injuries.
After Class: Each instructor will notify their gymnasts when class is over, at which time it is appropriate for gymnasts to return to the cubby area to put their shoes and socks back on.
Observers: Parents, siblings & visitors are NOT permitted on equipment at ANY time. Parents and/or caregivers are responsible for keeping children off equipment before, during or after class. Bleachers are provided for your convenience if you choose to stay and watch class.
Parking: Never park in the "NO PARKING ZONE" this area must remain clear at all times! Plenty of street parking is available. Please do not use the "no parking zone" to load or unload.
These expectations have been established to ensure that all who participate in the Girls Inc. of Greater Santa Barbara Gymnastics Program may do so in a safe environment and may enjoy a positive and enriching experience. By signing the below, I agree that my child and I will adhere to the policies set out by Girls Inc. of Greater Santa Barbara Gymnastics.
Admissions Agreement
Registration: Registration for classes is on a first-come first-served basis. Once you enroll in a class in a given season (Summer, Fall, Winter/Spring) you will be automatically registered for the same class for each month within that season thereafter. You must re-enroll for each new season. Registration fees are charged upon initial registration and collected once each calendar year.
Payments: All payments are due by the 5th of the month. All monthly fees are prorated (closures, holidays, extra days/weeks within the month). A child may be dropped from their class if payment is not received. Payments for camps are due upon registration. Spaces for classes or camp will not be reserved until payment is received.
Refunds and Credits: Refunds and credits will not be given for the days that child(ren) are absent except in cases of extreme emergency. By signing the Admissions Agreement, you are reserving space for you child even when your child is absent. Parents must contact the Gymnastics Director to request exception for this policy based on emergency situations.
Drop Policy: Written notice submitted a minimum of 10 days prior to a new month beginning is required to drop a class without being charged. Any child who drops without written notice will be charged the weekly rate of their respective class. A child who has not attended class for two consecutive weeks and has an unpaid account will be dropped for non-payment.
Late Pick-Up: For each ten minutes or portion thereof that you pick up your child past the end of his/her gymnastics class or camp you are subject to be charged $5. If needed, we will begin calling those listed on your emergency form to come and pick up your child. If after 30 minutes we have not been able to get in contact with anyone to pick up your child, we may need to contact the police.
Discipline Policy: Girls Inc. promotes self-discipline and establishes rules that are sensible and helpful in making each child feel safe and secure. For minor incidents of misbehavior an instructor will give a verbal warning and remind the child of expected behavior. In the event that a child is displaying behavior that is deemed unsafe to themselves or to others, the gymnastics staff will contact the parent/guardian and immediate pick-up may be necessary.
I agree to all rules stated above and that I'm in receipt of the Girls Inc. Gymnastics "Code of Conduct".