* For Online enrollment this form must be signed in person, before the first class attended!
1st
child’s FIRST NAME:
______________ LAST NAME:__________________ SEX: _______
DATE
OF BIRTH: ____________ SCHOOL: ________________________
2nd child’s FIRST NAME: ______________ LAST
NAME: _________________ SEX: _______
DATE OF BIRTH:
_____________ SCHOOL:
________________________
ADDRESS:
HOME
PHONE: _____________
FATHERS NAME:
________________ OCCUPATION _______________ WORK, /OTHER PHONE: _______________
MOTHERS NAME: ________________ OCCUPATION ______________ WORK /OTHER
PHONE: ______________
WHERE DID YOU
HEAR ABOUT GYMCATS? _____________________________________
THE FOLLOWING PARAGRAPHS MUST BE READ AND SIGNED BY THE
PARENT OR LEGAL GUARDIAN OF ALL MINOR STUDENTS OR BY THE STUDENT IF OF LEGAL
AGE.
LIABILITY
WAIVER: I AM AWARE THAT PARTICIPATION
IN THIS SPORT COULD BE A DANGEROUS ACTIVITY INVOLVING MANY RISKS OF INJURY,
INCLUDING BUT NOT LIMITED TO, SERIOUS HEAD OR NECK INJURY. PARALYSIS OR EVEN
DEATH. I HEREBY ASSUME ALL RISKS
ASSOCIATED WITH THE SPORT OF GYMNASTICS AND AGREE TO HOLD GYMCATS HARMLESS FROM
ANY AND ALL LIABILITY, CAUSES OF ACTION, DEBTS, CLAIMS OR DEMANDS OF ANY NATURE
WHATSOEVER WHICH MAY ARISE IN CONNECTION WITH PARTICIPATION IN THIS SPORT.
I, AS PARENT OR GUARDIAN, HAVE BEEN INFORMED OF THE RISKS INHERENT
IN THIS SPORT AS OUTLINED ABOVE AND AGREE TO HOLD GYMCATS, INC. AND STAFF
MEMBERS HARMLESS FROM ANY LIABILITY WHICH MAY ARISE OUT OF PARTICIPATION IN
CLASS TRAINING SESSIONS, RELATED ACTIVITIES OR TRAVELING TO AND FROM STATED
CLASS SCHEDULES OR RELATED ACTIVITIES.
SIGNATURE: __________________ DATE: _________
FOR ENROLLMENT
FINANCIAL
OBLIGATION: I ASSUME RESPONSIBILITY FOR
MEETING THE APPROPRIATE PAYMENT SCHEDULE.
PAYMENTS ARE DUE BY THE 1ST CLASS OF EACH SESSION FOR SESSION PAYMENTS
AND BY THE FIRST OF THE MONTH FOR TEAM MEMBERS WHO PAY MONTHLY. ANY CHILD
REGISTERED FOR A SESSION OR A MONTH IS OBLIGATED FOR THAT ENTIRE FEE. MID SESSION WITHDRAWALS WILL NOT BE
RECOGNIZED AND MAKE-UP CLASSES ARE FOR ILLNESS AND FAMILY EMERGENCY ONLY. MAKE-UPS WILL BE ALLOWED FOR STUDENTS WHO
ARE CURRENTLY ENROLLED ONLY IF THEY CAN BE ARRANGED BY ATTENDANCE IN A SIMILAR
CLASS WHICH IS NOT FILLED TO CAPACITY.
I ALSO UNDERSTAND THAT A LATE CHARGE OF $10 WILL BE ISSUED FOR LATE
PAYMENT. I UNDERSTAND AND AGREE THAT IF
MY CHILD WITHDRAWS FROM HIS/HER CLASS
AFTER ENROLLMENT, I WILL CALL OR WRITE THE FRONT OFFICE TO NOTIFY GYMCATS OF
THIS WITHDRAWAL..I, AS PARENT OR GUARDIAN, HAVE READ THE ABOVE AND BY SIGNING THIS
FORM I AM AGREEING TO THE PAYMENT SCHEDULE OUTLINED
ABOVE.
SIGNATURE: DATE
CLEARANCE TO PARTICIPATE
Students name:
Has recently had a physical examination and is permitted to participate
in sport, physical
education, or gymnastics training:
___________ Cleared for participation
(parents initials)
Limiting Conditions:
____________-----_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________
Name of Physician: _____________________________
Parents Signature:
_____________________________