Wainwright Gymnastics Club
2016 Winter Registration Form
CHILD’S NAME BIRTHDATE AGE SEX HEALTH CARE #
Month Day Year Years F/M
1) ______
2) ______
3) ______
PARENT(S) AND/OR GUARDIAN NAME(S): ______
MOM’S CONTACT #______DAD’S CONTACT #______
HOME/MAILINGADDRESS: ______
EMAIL ______ALTERNATE CONTACT______PHONE#______
Does your child have any special medical concerns/information(food/allergies/disabilities/behavioral)?
______
WGC WINTER SESSION REGISTRATION PAYMENT
Name______Class/Day/Time______$ ______
Name______Class/Day/Time______$ ______Name______Class/Day/Time______$ ______
10% off for 3 or more children Discount (______)
AGF Fee:$30.00 per child(If didn’t attend fall 2015 Session) $ ______
TOTAL: $ ______
FUNDRAISING
WGC requires that all families contribute to the sessions fundraising and will require a $100 deposit at registration.
Will your family be fundraising? YES______NO______
Opt out cheques will be deposited if your fundraising is not submitted by the due date. If fundraiser is completed, your Opt Out cheque will be shredded. For those of you who choose to not fundraise, your cheques will be deposited immediately.
………………………………………………………………………………………………………………………………………………
For Admin use only:
REGISTRATION Payment Received: CHEQUE #______CASH $______
FUNDRAISING Payment/Deposit Rec’d: CHEQUE # ______CASH $______
PAYMENT INFORMATION:
Payment in full is required at registration. Your child is not registered until payment is received or arrangements have been made/approved. For cancellations due to medical reasons, there will be a pro-rated refund, less registration fees of $30.00. Please note there is no fee adjustment when a member arrives late or leaves early. There will be no refunds given after the 3rd class for the Fall/Winter Session and after the 1st class of the Spring Session. Please make cheques payable to “Wainwright Gymnastics Club” and include Participant’s name on the memo line.
NSF cheques are subject to $40.00 charge.______A receipt will be issued after payment has been cleared through the treasurer.
Parent’s Initial
WGC WAIVER
I acknowledge and agree that gymnastics and other activities offered at Wainwright Gymnastics Club may involve a certain element of risk, which may result in bodily injury (including the risk of severe or fatal injury) to me or my child/ren (if signing on behalf of minor child).
I also acknowledge and agree that gymnastics requires the coach to perform some manual spotting which involves direct physical contact and is designed to assist the participant in the safe performance of the program skills.
I understand and agree that the Wainwright Gymnastics Club has tried to create a safe and controlled environment for participation and that the club has established rules for participation on and about the gymnastics area that must be followed by the participant.
I understand and agree that failure to comply with any of the policies and rules of the Club may result in the suspension or termination of membership or participation in the programs registered for.
I voluntary recognize and accept these physical risks and physical contact for spotting purposes and agree to abide by the “Gym Rules” as posted in the Club and/or dictated/ published/ circulated from time to time.
In consideration of Your acceptance of my participation or my child’s participation, I, intending to be legally bound, do hereby, for myself and my child, heirs, executors, and administrators waive the right to sue and release forever and discharge any and all rights and claims for losses, damages, and /or injuries which I and my child may have or may hereafter accrue to me or my child(if signing on behalf of minor child) against Wainwright Gymnastics Club, the organizers or their respective officers, agents, representative, employees, volunteers, officials, sponsors, directors, coaches, instructors or independent contractors and/or assigns for any losses, damages and injuries which may be sustained and suffered by me and/or my child in connections with our association with or entry in the above athletic activity or which may arise out of our participating in said athletic activity.
I have read this Waiver thoroughly and I understand and accept the conditions of enrollment:
______
Participant’s Signature/Parent or Guardian if under 18years old Date
RECORD OF MEDICAL CONSENT FOR MINORS
I, ______, give my permission for emergency medical/surgical care to be given by Canadian Physicians forming part of the event team or by such local practitioners as they see fit to select for ______, who is my daughter/son. I confirm that I, or my child am/is fit to participate in gymnastics and I am unaware of any physical or mental conditions or impediment, which would prevent or hinder myself or my child from participating safely in the programs at Wainwright Gymnastics Club. I confirm that I have accurately reported and disclosed any medical information (physical and mental), which is necessary for the proper gymnastics involvement and care of the above mentioned child/person. I understand and agree that, in the case of an emergency, Wainwright Gymnastics Club assumes no responsibility or obligations relative to any cost or expense related to carrying out any emergency procedures, and/or emergency transportation for myself or my child. I hereby authorize basic first aid to be delivered to my child or myself by Wainwright Gymnastics Club or other authorities. By administering basic first aid when required or requested, Wainwright Gymnastics Club in no way warrants or assumes any liability in relation to the administrator of such basic first aid. It is understood that whenever possible I shall be contacted, informed or the situation, diagnosis, and treatment required and the hoped for results. Unless otherwise specified in writing, any athlete needing emergency hospital care will be sent to the Wainwright Hospital.
______
Parent or Guardian Signature Date
I hereby give Wainwright Gymnastics Club the right to publish the name of the above child(ren) in its monthly newsletters or use photos taken throughout the year to use on the web (webpage, Facebook). As well, I am aware that my information may be shared with the Alberta Gymnastics Federation and or Gymnastics Canada.
______
Parent or Guardian Signature Date
Parent & Tot (Children 18-36 months with Parent)
This program is great for developing motor skills by playing games and doing simple gymnastics circuits, in a fun and stimulating environment.
Monday 4:30 to 5:15pm ______$115.00 ______
Wednesday 4:00 to 4:45pm ______$125.00 ______
Tiny Tots (For 3 year olds)
This is an intro to gymnastics without parents. Tiny Tots is a great way to develop motor skills and learn the basics of gymnastics.
Monday 5:15 to 6:00pm ______$115.00 ______
Wednesday 4:30 to 5:15pm ______$125.00 ______
Preschool (For 4 year olds)
Children will learn basic gymnastics, with music and games. This program is also very beneficial for the development of motor skills, coordination, and balance, in a fun environment.
Monday 4:30 to 5:30pm ______$140.00 ______
Wednesday 4:30 to 5:30pm______$150.00 ______
The CANGYM classes are specifically designed to introduce the young gymnast to the sport. There are 14 levels in the CanGym program. The 1 and 1 ½ hour classes are for those working on the first 4 badges. Two Hour class is for the 5th badge and up
1 hour CanGym (Burgundy to Bronze)
Monday 6:00 to 7:00pm ______$160.00 ______
Wednesday 5:30 to 6:30pm ______$175.00 ______
Thursday 4:30 to 5:30 pm ______$175.00 ______
1½ hours CanGym (Tan to Bronze)
Monday 5:30 to 7:00pm ______$230.00 ______
Monday 7:00 to 8:30pm ______$230.00 ______
Wednesday 5:30 to 7:00 pm ______$250.00 ______
Wednesday 6:30 to 8:00pm ______$250.00 ______
2 hours CanGym (Purple and Up)
Monday 6:30 to 8:30 pm ______$275.00 ______
Wednesday 6:30 to 8:30pm ______$300.00 ______
4 hours CanGym (Purple and Up)
Mondays & Wednesdays 6:30 to 8:30pm ______$525.00 ______
Our Boys program also follows the 14 level CanGym program. All 6 mens’ apparatus (rings, pommel horse, parallel bars, floor, vault and high bar) are taught in this program.
Boys 1 Hour
Thursday 5:30 to 6:30 pm ______$175.00 ______
Boys 2 hours
Thursday 6:30 to 8:30pm ______$300.00 ______
Teen (For 12-18 year olds)
This class is geared towards teens who want time in the gym to work on new skills or to perfect old ones. Gymnastics is a fantastic way to stay in shape, meet new friends, and build on your confidence and self-esteem.
Thursday 7:30 to 8:30pm ______$150.00 ______
BY INVITATION ONLY
Little Stars/Level 1 (Ages 4-6 year olds)
This 2 hour class is once a week for children who show potential in the sport. This class will focus on flexibility, strength, and body alignment that one would need to do the complex skills of gymnastics.
Thursday 5:30 to 7:30pm ______$275.00 ______
Super Girls/ Level 2 23 WEEK PROGRAMJanuary 4 and end June 18
Monday &Wednesday 4:30 to 6:30pm ______$700.00 ______
Wainwright Gymnastics Club
For Information: Call: (587) 281-1667
Email:
Welcome to the General Gymnastics Program!
To ensure you and your child are as well prepared as you can be for your gymnastics experience, please make note of the following:
GYM ATTIRE:
-Body suits or t-shirt and shorts.
-Please make sure there are no buttons, zippers, or anything that could catch on equipment or could injure the gymnast during their lesson.
-Hair should be secured back off the face and neck with elastics, barrettes or clips.
-All jewelry needs to be removed. Only stud earrings will be allowed.
-Failure to follow the above instructions, will result in non-participation on various equipment (i.e.bars, beam and trampoline)
FOOTWEAR:
-Bare feet are required and are the safest
-If your child has any medical concerns with his/her feet (i.e.plantar warts or open sores), rubber bottom slippers or athletic tape MUST be worn (apply before class)
-NO outside footwear is allowed in the gym.
PARENT ATTIRE FOR PARENTED CLASSES:
-Comfortable athletic wear.
-No shoes in the gym. Socks are allowed for parents.
-Parents should come prepared to ACTIVELY participate in the class.
ARRIVING FOR CLASS:
-Please be on time for all classes. Tardiness disrupts the class and jeopardizes the safety of your child, as there is only one warm-up offered at the start of each class.
-Please ensure your child uses the washroom just before class. The only washroom we have access to is downstairs.
-For Tiny Tots, Preschool and Little Stars: Parents will be required to sign in and out their child at the Admin desk before they are released from the Wainwright Gymnastics Club.
-Children must stay outside of the gym until the instructor calls their class in.
VIEWING POLICY:
-Parent Viewing is only the First 7 Days of the Month
-Please refrain from any communication with class participants during class time.
-Please NO Flash photography.
-Please turn off or silence all electronic devices.
-This policy is for the safety of both the viewers and the participants.
FUNDRAISING:
-Fundraising keeps our gym fees low, so that more families can afford and enjoy the sport.
-Every family is required to either fundraise or pay an “Opt-Out” fee.
-See Registration Form: Payment Section
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