Assumption of Risk
Mr. Todd's Membership Agreement - Waiver/Release Form
Read the following carefully and sign below. NOTE: Parent signs if student is under 18 years.
Agreement
In consideration of my membership at Mr. Todd's Gymnastics, and my participation in Mr. Todd's Gymnastics classes, team program, events, and activities, I agree to be bound by each of the following:
1) Eligibility: I agree to comply with the rules of Mr. Todd's Gymnastics.
2) Readiness to Participate: I will only participate in those Mr. Todd's Gymnastics classes, team program, events, competitions, and activities for which I have accomplished the degree of confidence necessary to perform them by myself, and without injury.
3) Medical Attention: I fully understand that Mr. Todd's Gymnastics staff members are not physicians or medical practitioners of any kind. With the above in mind, I hereby release the Mr. Todd's Gymnastics staff to render temporary, but trained first aid to my child or children in the event of any injury or illness. Also, if deemed necessary by the Mr. Todd's Gymnastics staff to seek medical help, including calling of an ambulance for said child should the Mr. Todd's Gymnastics staff deem this to be necessary.
4) Waiver and Release: I am fully aware of the risks, including the risk of catastrophic injury, paralysis, or even death, as well as other damages and losses associated with participation in gymnastics activities and events. I further agree that Mr. Todd's Gymnastics, and the sponsor of any Mr. Todd's Gymnastics event, along with the employees, agents, officers, and directors of these organizations shall not be liable for any losses or damages occurring as a result of my participation in the event, except where such loss or damage is the result of the intentional or reckless conduct of one of the organizations or individuals identified above.
5) COVID-19: Before sending your child to Mr. Todd's Gymnastics, we want to make sure you understand that in light of the current medical, legal and economic conditions resulting from the COVID-19 pandemic, and recognizing that these conditions are subject to abrupt change at any time, you are sending your child to Mr. Todd's Gymnastics under the following conditions:
While we wish that we could control every possible risk, and while we will use our best efforts to keep your child safe from COVID-19 virus, we want to make clear that we cannot promise or guarantee that this or any other pathogen will not enter our facility. We want you to be fully aware of this risk in making your decision to send your child to gymnastics, and that you are willing to assume and accept it on your child's behalf. In order to minimize the risk, you agree that before allowing your child to attend Mr. Todd's Gymnastics that your child and any other person in your household has not been in contact with any persons diagnosed with COVID-19 within the last 14 days.
6) Parent should make their children aware of the possibility of injury and sickness and encourage their children to follow all the safety rules and the coaches' instructions.
7) The Mr. Todd's Gymnastics, its coaches and other staff members, will not accept responsibility for injuries or sickness sustained by any student during the course of gymnastics, tumbling, dance or cheerleading instruction, or open workouts, privates or in the course of any exhibition, competition, or clinic in which he or she may participate or while traveling to or from the event.
8) I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage which I consider adequate for both my child's protection and my own protection.
For any athlete who is not yet 18 years old: As legal parent or guardian of this athlete, I hereby verify that I fully understand and accept each of the above conditions for permitting my child to participate in classes, team practice, events, day program, competitions and all activities conducted by Mr. Todd's Gymnastics.
COVID-19 Screening Form
SCREENING FORM
Mr. Todd's Gymnastics, 12 Olympic Way, Poughkeepsie NY 12603
www.mrtoddsgym.com
All of the below answers to these questions must be NO in order for your child to attend class.
1. Have you or your child knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had symptoms of COVID-19? Contact is defined as being within 6 feet (2 meters) for more than 15 minutes with a person, or having direct contact with infectious fluids from a person with confirmed COVID-19 (for example being coughed or sneezed on).
2. Have you or your child been tested for COVID-19 in the past 14 days?
3. Have you or your child had a positive-COVID test for active virus in the past 14 days?
4. Have you or your child been outside of NYS? (not including CT, NJ or PA) In order to continue to the next section, you must have received a negative Covid test upon returning. If you have not, unfortunately you and your child will not be able to sign up for classes at this time.
5. Do you or your child have any of these symptoms that you cannot attribute to another condition?
• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• Recent onset of loss of taste or smell
• Sore throat
• Congestion
• Nausea or vomiting
• Diarrhea
If the answer is yes to any of these questions unfortunately you and your child will not be able to sign up for classes at this time. We apologize for any inconvenience but we are taking these precautions to keep our families safe.
I verify that all these answers are answered no. If at any time through the course of my child's participation in activities at Mr. Todd's Gymnastics, these answers should change, I will notify MTG management IMMEDIATELY. I will do so in writing to marisahart@optonline.net .
By agreeing to this form you verify that all your answers are NO to all of the above questions
Payment Policies
Mr. Todd's Gymnastics
Policies & Rules
Effective 7/28/2020
Membership/Registration Fee
*Membership/Registration is $40.00 single student and $60 per family and is due at the time of initial sign up. If a second child signs up later, then the $20 difference is due at sign up and the family registration date becomes that of the first child. The registration is good for one year from the time of sign up unless you have become inactive at which time, if you return, you will be charged a re-registration fee. Membership/Registration entitles you as a member to sign up for classes during the closed enrollment period and discounts on other activities in the gym.
PLEASE NOTE: Membership/Registration is not refundable under any condition.
Session Tuition
Tuition is the cost of each child's class for one class per week based on an eight week session. The session dates vary year to year based on the calendar. Tuition payment is due in full at sign up for each session. No spots will be held without full payment.
* A $30.00 fee will be charged to any returned check.
* Tuition for sign-ups done mid session will be pro-rated for that session and that session only or, you have the option of making up classes.
* If you cancel from a session before it begins, then you are entitled to a 50 % refund or credit for that session. If you cancel once a session has started, then no refunds or credits will be given. NO EXCEPTIONS to this refund policy!!
Session Policies
1. To continue with the same class for the next session, you must enroll during the closed
registration period. If you miss it, there is no guarantee of a spot in that session even if
you are a member!
2. To change a class for the next session, you must re-enroll in the class you are currently in unless you have paid for that session in advance. Once open registration begins, you may transfer to another day and time depending upon availability.
3. It is the parent's responsibility to be aware of sign up dates, session start and end dates and gym closings. This information is posted around the gym and on the web page for your convenience.
NOTE: We hope that all students will continue throughout the entire session. If you decide not to return to class and do not make any proven attempt to contact us, then we have no choice but to assume that you will not be returning and can not guarantee a spot in the next session. If you are not going to return, we would appreciate a call letting us know this and the reason for returning. This information will help us to continue to provide a great, family oriented place for you and your kids! We understand the trials and tribulations of working families and we are here to help and work with you.
Discounts
10% discount for enrollment in two or more classes.
10% discount for all other family members. *Fourth member is free. After 4th free child; process starts
over again.*Rule applies only to recreational classes not our competitive program
10% discount for full pre-payment of two consecutive sessions. 1
15% discount for full pre-payment of four or five consecutive sessions.1
NOTE 1 - Same cancellation policy applied (SEE ABOVE)
Make-Ups
One make-up per session is permitted for the following reasons:
* Everyone receives one missed class; due to sickness or family obligation.
* Closings due to weather, facilities etc. (We cancel)
** To find out if the gym is open or closed due to inclement weather or planned closings, FIRST please try checking www.cancellations.com before you call the gym.
If your child has missed a class, or classes, then it is the parents' responsibility to re-schedule a make-up during any other time slots for that particular class within that session of the missed class. If the class is missed during the last week of the session, it may be carried over to the next session. If you are not continuing into the next session, then the class is lost. If you know ahead of time that your child is going to miss classes, you may schedule a make up prior to the missed class. PLEASE NOTE: Make-ups MUST BE SCHEDULED AHEAD OF TIME! Walk-ins for make-ups may be turned away if the class is full or we do not have ample assistance.
Make-ups will not be permitted for the following reasons:
• Holidays (Unless otherwise noted)
• Planned Gym Closings (vacations)
• A class missed from any previous session.
Gym Rules
At Mr. Todd's Gymnastics we feel there are certain qualifications and standards that are necessary to ensure a safe, secure and satisfying gymnastics environment in our facility. Therefore, we enforce the following rules and ask that you review them with your child:
* Please escort your child into the gym and to and from the parking lot.
* No shoes in the carpeted or matted gym areas please. Bare feet, socks or acro-shoes are allowed.
* Any non-students (parents, siblings, etc) are not allowed past the bathrooms during classes except for parent participation classes.
* No jeans, jean shorts or any other clothing with metal.
* No running in the gym unless instructed.
* No one may go on any equipment at any time without an instructor present.
* Proper attire is required. Girls should wear leotards but not with skirts or gems below the waist and shirts should be able to be tucked in. Warm up suits and socks are optional. Boys should wear t-shirts and shorts or sweat pants. No jewelry may be worn. Long hair must be tied off the face with no metal clips in the hair.
* * No food, gum, candy, or drinks are permitted in the gym area.
* Horseplay will not be allowed.
* Please no tumbling out of the gym area.
* Students arriving for class are asked to wait by the fence near the main entrance for the instructor to call them out. At this time, shoes must remain on.
* No new skills may be attempted without an instructor's permission.
* Parents: Please watch over any younger children. Please be considerate of disruptions or distractions to the class and students. * Please do not talk to your child during class.
* A positive attitude is required at all times! :-)
The Staff at Mr.Todd's Gymnastics
I agree that I fully understand and will adhere to the above rules, regulations and policies. I also agree that no member of my household has knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or has had symptoms of COVID-19. If this should change, I WILL not return my child to gymnastics for 14 days and I WILL inform MTG. Thank you for helping keep all our families safe.
Concussion Safety Protocol
Concussion Safety Protocol
Mr. Todd's Gymnastics (MTG) is committed to protecting the health of and providing a safe environment for each of its participating athletes. We recognize that gymnastics is a high-risk sport for concussion. To this end, MTG has adopted the following Concussion Safety Protocol for all athletes. This protocol identifies expectations for the club's concussion management practices as they relate to (1) the definition of sport-related concussion; (2) preseason education; (3) recognition and diagnosis; (4) post-concussion management; (5) return-to-learn & sport; and (6) limiting exposure to head trauma.
1. Definition of Sport-Related Concussion
The Consensus Statement on Concussion in Sport, which resulted from the 5th international conference on concussion in sport, defines sport-related concussion as follows:
Sport-related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. Several common features that may be utilized to clinically define the nature of a concussion head injury include:
• SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.
• SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms evolve over a number of minutes to hours.
• SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
• SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged.
2. Preseason Education
All athletes and parents of minor athletes will be provided and allowed an opportunity to discuss educational material (e.g., the USAG Sports Concussion Overview) and be required to sign an acknowledgement, on an annual basis and prior to participation, that they have been provided, reviewed and understood the concussion education material.
All coaches involved in athlete health and safety decision making are required to complete concussion education training prior to coaching and annually thereafter. Coaches must be allowed an opportunity to discuss educational material (e.g., the USAG Sports Concussion Guidelines, the USAG Sports Concussion Overview) and be required to sign an acknowledgement, on an annual basis, that they have been provided, reviewed and understood the concussion education material.
Concussion education should include:
• The definition of concussion
• Possible mechanisms of injury
• Common signs and symptoms
• Steps that can be taken to prevent concussions and other injuries from occurring in gymnastics
• What to do when an athlete has suffered a suspected concussion or more serious head injury
• What measures should be taken to ensure proper medical assessment
• Return-to-School and Return-to-Sport Strategies (See USAG return to sport progression for gymnastics-specific progressions for each discipline)
• Return to sport medical clearance requirements
3. Recognition and Diagnosis of Concussion
All coaches in a member club must be able to recognize the potential mechanism of injury of a concussion and the signs and symptoms of acute concussion. Coaches must immediately discontinue training or competition for anyone who is suspected of having a concussion and must monitor the athlete until a parent arrives. Coaches must be able to recognize red flag signs and symptoms and must activate 911 if these signs and symptoms are present.
Medical personnel with training in the diagnosis, treatment and initial management of acute concussion will be present at all high-risk USAG sanctioned competitions.
Any athlete that exhibits signs, symptoms or behaviors consistent with concussion:
• Must be removed from practice or competition until they are evaluated by a medical professional.
• Must be evaluated by a physician (or physician designee) with concussion experience.
• May only return to play the same day if onsite medical personnel determine that concussion is no longer suspected.
4. Post-concussion Management
Activation of emergency action plan must occur for any of the following scenarios following a suspected concussion:
¦ Severe or worsening headache
¦ Weakness or numbness in the arms or legs
¦ Vomiting
¦ Slurred speech
¦ Neck pain
¦ Double vision
¦ Seizure activity or convulsions
¦ Agitated or combative
¦ Loss of consciousness or deteriorating conscious state (going in and out of consciousness)
Because concussion may evolve or manifest over time, for all suspected or diagnosed concussions, athlete should be monitored by club personnel trained in concussion until a parent arrives. An athlete should never be allowed to drive him/herself home after a suspected concussion.
For all cases of suspected or diagnosed concussion, there must be documentation that post-concussion plan of care was communicated to both the athlete and another adult responsible for the athlete, using the USAG Sports Concussion Information form.
5. Return-to-Learn & Sport
Prior to return to gymnastics after a concussion event, the athlete must be symptom free with all activities of daily living and academic activities. Performance of academic activities must be back to the athlete's baseline and without modification.
Return-to-sport progressions should not begin until the athlete has completed an unrestricted return-to-learn progression. Initiation of the return-to-sport protocol must be approved by a physician or his/her medically qualified designee.
The timeline for return-to-sport varies based on individuals and other medical conditions including prior history of concussion. It generally takes longer for children and adolescents to return-to-sport than it does for adults.
Final determination of unrestricted return-to-sport will be made by a physician or his/her medically qualified designee following implementation of an individualized, supervised stepwise return-to-sport progression detailed in the USA Gymnastics Gymnastics- Specific Return-to-Sport Strategy document that includes:
1. Rest followed by light aerobic activity.
2. Return to early sport training: Inversion.
3. Progress sport specific training: Flipping.
4. Progress sport specific training: Twisting.
5. Progress sport specific training: Advanced Skills (physician clearance required to move to step 6).
6. Return to full training.
The above stepwise progression will be supervised by a health care provider with expertise in concussion, with it being typical for each step in the progression to last at least 24 hours.
NOTE: If at any point the athlete experiences a return of concussion-related symptoms, they should go back to the previous stage that they completed symptom-free, wait for symptoms to resolve (minimum 24 hours), and then begin the progression again. The minor athlete's parent should always be notified if the athlete becomes symptomatic.
7. Limiting Exposure to Head Trauma
MTG is committed to protecting the health of and providing a safe environment for each of its participating athletes. We will provide a safe environment for our athletes by:
1. Ensuring gymnasts have completed proper progressions prior to trying a new skill.
2. Using proper mats and equipment setup.
3. Having spotters in place at practice and during competition.
4. Ensuring the area is clear prior to beginning a skill to prevent collisions.
5. Ensuring equipment is properly maintained and inspected.
By accepting this form, I hereby acknowledge, that I will adhere to the club's Concussion Safety Protocol for my child.
