IGNITE CHEER TUMBLING CENTER, LLC
SUMMER DAY CAMP-REGISTRATION FORM
Athletes Name______Age______Birthdate______Gender______
Address______City______Zip Code______
Parent #1 Name______Parent #1 Cell/Work Phone#______
Parent #2 Name______Parent #2 Cell/Work Phone#______
Preferred Email: ______
Emergency Contact Name______Emergency Contact Phone#______
Registration Fee: $______
Camp Tuition: $______
Total Enclosed: $______
T-Shirt Size:YS- YM- YL- S- M- L- XL
Payments are accepted at the gym in the form of cash, check or credit card, or online with credit card
REFUND POLICY: Registration fees are non-refundable. Tuition fees will not be refunded once a session begins.
How did you hear about us? ______
Medical Information: Please list any medical conditions of which we should be aware (Examples: Asthma, hearing
loss, back injury):______
Are any medications being taken which could cause disorientation, loss of balance, perceptual difficulties? Even
over the counter products can have an effect, please list anything being taken, even temporarily:______
______
Snack will be provided for the campers. Please list any food allergies: ______
______
Please do not write below this line, for office use only
Camp Session:_____ Date Received:______Reviewed by:______Amount:______Payment:______Pd:____
IGNITE CHEER TUMBLING CENTER
DISCLAIMER, WAIVER AND RELEASE FORM
DISCLAIMER: Ignite Cheer Tumbling Center, LLC is not responsible for any injury (or loss of property) to any person while practicing, training, taking class, participating in open gym, special events, demonstrations, exhibitions, or shows, or in any other way involved in gymnastics, cheerleading, preschool, or classes at Ignite Cheer Tumbling Center, LLC, for any reason whatsoever, including ordinary negligence on the part of Ignite Cheer Tumbling Center, LLC, its owners, officers, agents, or employees.
Ignite Cheer Tumbling Center, LLC staff members are not physicians or medical practitioners of any kind. With the above in mind, by signing below you hereby authorize the Ignite Cheer Tumbling Center, LLC staff members to render temporary first aid to my child or children in the event of any injury or illness, and if deemed necessary by the Ignite Cheer Tumbling Center staff members to seek medical help by the calling of an ambulance for said child should the Ignite Cheer Tumbling Center staff deem this to be necessary.
We, the staff of Ignite Cheer Tumbling Center, LLC hereby make our students and their parents aware of the risks and hazards associated with the sport of tumbling and cheerleading. Students may suffer injuries, possibly minor, serious, or catastrophic in nature. Tumbling, and Cheerleading can be dangerous and can lead to injury.
Parents should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and the coaches' instructions. By signing below you acknowledge that you understand that it is the parent’s responsibility to warn the child about the dangers and injury. The parent should warn the child according to what the parent feels is appropriate. Ignite Cheer Tumbling Center will only warn the child through safety messages, and our teaching style and progressions. Ignite Cheer Tumbling Center, its coaches and other staff members, will not accept responsibility for injuries sustained by any student during the course of tumbling, cheerleading or open workouts in which he or she may participate or while traveling to or from any event. With the above in mind, you acknowledge that you are fully aware of and appreciate the risks of catastrophic injury, paralysis, and even death, as well as other damages and losses associated with participation in tumbling, and cheerleading activities and events. By signing below you also affirm that you now have and will continue to provide proper hospitalization, health, and accident insurance coverage, which you consider adequate for both your child's protection and your own protection. You hereby verify by your signature below that you fully understand and accept each of the above conditions for permitting your child to participate in any activities at Ignite Cheer Tumbling Center.
LIABILITY RELEASE: I, (we) despite all reasonable precautions implemented for safety, am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis and even death, as well as other damages and losses associated with participation in Ignite Cheer Tumbling Center, LLC’s programs or activities. I knowingly and willingly assume all such risks. Consequently, and in consideration of my or my child’s participation, I hereby for my child, myself, heirs, executors and administrators, do waive and release any and all rights and claims for damages against the owner, operators, coaches and other members of Ignite Cheer Tumbling Center, LLC from property damage, personal injury, wrongful death, or accident of any sort or nature suffered by me, the undersigned, or my child by reason of participation or membership in classes, lessons, instruction in gymnastics, cheerleading, or any other activities of Ignite Cheer Tumbling Center, LLC or any activities incidental thereto, wherever, whenever, or however the same may occur.
I understand that this waiver is intended to be as broad and as inclusive as permitted by the laws of the state of New York and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be within the state of New York.
Further, I further agree to indemnify and hold harmless Ignite Cheer Tumbling Center, LLC.,the owner, operators, coaches and other members of Ignite Cheer Tumbling Center, LLC for any and all claims arising as a result of my engaging in or receiving instruction in Ignite Cheer Tumbling Center, LLC. activitiesor any activities incidental thereto, whenever, wherever, or however the same may occur.
Athlete’s Name:______Birth Date:______
Parent or Guardian Signature: ______Date: ______.
At times we may use photos of our athletes on our web site, ignitecheertumbling.com. In addition, we sometimes use photos of our athletes on videos and various other advertising and promotional media. If you DO NOT want your child’s picture displayed please check the box below.
I DO NOT give permission to Ignite Cheer Tumbling Center, LLC.to use photos of my child for anyreason.