Loading...

IGM Gymnastics Open Gym/Special Event/Birthday Party Release of Liability Waiver

WAIVER OF LIABILITY, CONSENT FOR MEDICAL TREATMENT, AND INDEMNITY AGREEMENT Read Carefully Before Initialing: In consideration of the benefits to be derived from participation in the gymnastics activities offered by IGM Gymnastics, and with the understanding that participation is only on condition that I enter this agreement, the Parents or Guardians and the Gymnast named below agree to the following Waiver of Liability, Consent for Medical Treatment and Indemnity Agreement: The parent(s) and/or legal guardians will instruct the minor participant that prior to participating in the gymnastics activities described below he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate. I understand and agree that, if at any time, I feel anything to be UNSAFE, I will immediately take all precautions to avoid the unsafe area and refuse to participate further. 

A. PERSONAL INJURY


1) I fully understand and acknowledge that gymnastics is a vigorous, challenging, and sometimes DANGEROUS activity involving heights and balance, and as such it poses a risk of serious injury.
2) I understand that injuries from participation in gymnastics activities may include, but are not limited to, injury to internal organs, bones, ligaments, tendons, muscles, and other parts of the body and could result in partial or total paralysis and even death.
3) I understand that there may be other risks that are not known or are not reasonably foreseeable at this time.
4) I understand that injuries received may be compounded or increased by negligent rescue operations or procedures of IGM staff.
5) I understand that participation in gymnastics activities also includes activities incidental to participation, including moving from event to event, conditioning, stretching, and other activities which may render the participant vulnerable to other participants who may not have complete control over their actions during flipping, rotating, or running, and may not see other participants in the area.
6) I understand that such injuries could result in severe economic and social losses or damages.
7) I understand that despite the use of mats, pits, and other safety equipment and the active participation or supervision of a coach or teacher, such injuries will NEVER be eliminated from participation in gymnastics.
8) With full understanding of the above, I agree that I am voluntarily participating in this activity with the knowledge of the risks involved and hereby freely and expressly agree to accept any and all risks. I hereby release and covenant not to sue IGM, for any personal injury or wrongful death arising out of participation in its gymnastics activities however caused and whether caused in whole or in part by negligence attributable to IGM. I hereby voluntarily waive any and all claims, both present and future, made by me, my family, estate, heirs, or assigns. 

B. MEDICAL AUTHORIZATION


1) I hereby grant authority to the staff of IGM to make decisions concerning medical assistance or hospital care for the gymnast named in the event of an accident or illness during my absence.
2) I agree to pay all fees and charges resulting from medical assistance or hospital care accessed by IGM for the gymnast named in the event of an accident or illness during my absence. 

C. LOSS OF PROPERTY


1) IGM is not responsible for any injury or loss of property, to any person while participating in gymnastics activities for any reason whatsoever, including ordinary negligence on the part of IGM, its owners, employees, officers, contractors, agents, or other participants. 

D. INTERPRETATION, INDEMNITY AND CONSENT



1) I understand that this Waiver Consent and Indemnity Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Minnesota, and agree that if any portion is held invalid, the remainder of the Waiver Consent and Indemnity Agreement will continue in full force and effect.
2) I agree to indemnify and hold harmless IGM and all others listed for any and all claims arising as a result of participation in gymnastics activities, or any activities incidental thereto, wherever, whenever, and however the same may occur.
3) I affirm that I have read and fully understood this waiver consent and indemnity agreement, understand that I have given up substantial rights by signing it.

First Participant's Name
First Name*
Last Name*
Select Gender
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Select Gender
Participant's Date of Birth*
Date of Birth
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Relationship*
Phone*
Select Gender
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!