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Perfect Storm Athletics
(Perfect Storm Athletics Ltd., Perfect Storm Athletics (Lethbridge) Ltd.,
Perfect Storm Athletics (Calgary) Ltd.),
Perfect Storm Athletics (Sherwood Park) Ltd.)

Participant's or Parent's / Legal Guardian's Informed Consent, Indemnity, Medical Release and Waiver

Today's Date: November 22, 2019

Please read carefully before signing.

To sign a waiver, you must be 18 or over and if this is for a minor, it must be completed and signed by a parent or legal guardian.

Signing this document means I understand it entirely (not just this bold portion) and agree to its contents. My signature means, in part, that I understand participation in an activity at, or a class or program of Perfect Storm Athletics Ltd., Perfect Storm Athletics (Lethbridge) Ltd., Perfect Storm Athletics (Calgary) Ltd. or Perfect Storm Athletics (Sherwood Park) Ltd. can be risky and dangerous and may result in serious injury or death to me or my child, but that I will not sue or bring any action against Perfect Storm, or anyone associated with Perfect Storm.

To: Perfect Storm Athletics Ltd., Perfect Storm Athletics (Lethbridge) Ltd., Perfect Storm Athletics (Calgary) Ltd., Perfect Storm Athletics (Sherwood Park) Ltd. and their respective directors, officers, employees, agents, successors and assigns, (together, "Perfect Storm")

I, the undersigned parent or guardian, do hereby grant permission for my daughter / son (hereinafter referred to as "Participant"), whose name is printed above, to participate in the activities and programs held by Perfect Storm, and agree to the contents of this document.

OR

I am over the age of 18 and am participating in the activities and programs of Perfect Storm (I shall also be referred to as "Participant".) and agree to the contents of this document.

  1. Assumption of Risk. I acknowledge that all programs and activities of Perfect Storm including, but not limited to cheerleading, dance, tumbling and fitness classes, team training, practices, open gyms, performances, competitions, demonstrations, parades, community promotions and travelling to and from such activities, whether held at the premises of Perfect Storm or elsewhere, and no matter how or where the travel is conducted (collectively referred to as the "Activities") are physical activities that involve running, jumping, kicking, lifting, rotation, and coordinated body movements. I agree that participation by the Participant in any Activity involves inherent physical risks and I agree to assume the full risk of any bodily injuries (including death), damages, or loss which I / the Participant may sustain as a result of any activities or travel arising out of, connected with, or in any way associated with participation in the Activities. I certify that the Participant's present level of physical condition is consistent with the demands of active participation in the Activities.
  2. Waiver. I agree that I, my heirs, next of kin, executors, administrators and assigns (collectively "my Successors") do hereby fully release Perfect Storm from any and all liability, claims and causes of action arising from any injury, damage or loss I / the Participant may sustain as a result of any activities arising out of, connected with, or in any way associated with my / the Participant's participation in the Activities and covenant not to sue Perfect Storm for the same, whether caused by the negligence of Perfect Storm or otherwise. This is a complete and irrevocable release and waiver.
  3. Indemnity. I agree to indemnify, hold harmless and defend Perfect Storm from any and all claims arising out of or in consequence of my / the Participant's participation in Activities. This indemnification includes, but is not limited to legal fees.
  4. Medical Authorization. In the case that I / the Participant sustains an injury or medical emergency during activities relating to the Activities, I authorize the owners, directors, staff, or other associated representative of Perfect Storm to act for me / the Participant, according to their judgement, seeking immediate treatment and / or the necessary emergency care for me / the Participant. This authorization DOES NOT require a prior determination of a threat to my / the Participant's life or a danger of serious permanent injury. I hereby hold the owners, directors, staff or other associated representatives of Perfect Storm harmless in the exercise of this authority.
  5. Emergency Transport. I authorize and agree to pay any expense incurred for emergency transport or treatment for the Participant.
  6. Authorization for Photo/Video Use & use of contact info. I authorize Perfect Storm to use photographs, video recordings or any other likeness of myself / the Participant in its promotional or sales materials, advertisements, web site, Facebook, and I hereby waive any right to compensation or any claim of ownership thereto. I agree to receiving a follow up email from Perfect Storm, understanding I have the ability to opt out of all further emails.If the Participant is active on a Perfect Storm cheer or dance team, I also authorize Perfect Storm to release my contact information to the parents association, team "Mom" / representative and coaches for purposes of providing fundraising & related information to me and for communicating with me regarding Perfect Storm Activities.
  7. GYM RULES & Policies. I have read, understand and agree to the Perfect Storm Gym Rules & Policies below. I understand they are designed for the safety and protection of me / the Participant and I hereby agree to inform my child (the Participant) of the risks of the Activities and the importance of abiding by the Rules & Policies.
    1. Use of the equipment (including trampoline, Tumbl Trak, climbing ropes, blocks, etc) is strictly forbidden without the proper supervision of a qualified Perfect Storm Athletics coach.
    2. The Supervising Coach is in charge. The Supervising Coach has the authority to refuse or expel anyone from the gym.
    3. Horseplay, rude behavior, shouting, swearing and bullying is not tolerated.
    4. Open Gym is for ages 7 and up. Participants need to be able to train safely and independently without parental guidance.
    5. Parents, family members and visitors are not allowed past the "purple line" in the parent viewing area unless with the advanced permission / direction of a gym owner or Supervising Coach.
    6. All accidents/incidents must be immediately reported to the Supervising Coach or gym owner.
    7. All equipment must be returned to its original place by the user.
    8. One person at a time on the trampoline.
    9. No flips or head-first or prone entries into the pit (no head or prone falls). Feet-first only.
    10. Any skill which is unfamiliar to a Participant must not be performed without supervision by a certified coach.
    11. There shall be NO spotting of skills unless done so by a coach certified at the level of the skill(s).
    12. The gym is an indoor shoes only facility. Athletes / Participants, parents & visitors are all required to take their footwear off upon entering the facilities & place them on the boot-racks in the lobby. Appropriate indoor gym shoes only are allowed in the Perfect Storm gym.
    13. No smoking. Drugs and alcohol are strictly prohibited. Anyone appearing to be under the influence will be immediately removed from the gym.
    14. Jewelry and piercings of any kind are not allowed in cheer team practices or classes. Wearing of any piercing at open gym is done so at the sole risk of the Participant.
    15. Long hair must be tied back.
    16. No jeans or ripped pieces of clothing allowed.
    17. No gum, candy, food or drink (except water) allowed past the viewing area.
    18. When and if required, the Supervising Coach will implement the Emergency policy and procedures.
    19. No loose objects or equipment (balls, hoops, etc.) allowed on trampoline.
    20. Proper equipment set-up and safety mats must be in place at all times for all skills at all levels.
    21. Perfect Storm Athletics has a nut allergy alert in effect. Nut products are not allowed in the gym.
    22. Perfect Storm Athletics is not responsible for lost or stolen property. Look for lost items in our Lost & Found bin, located in the parent viewing area. Valuables should be left at home.
    23. Bullying, Harassment and Sexual Misconduct: Perfect Storm Athletics prides itself in creating a positive and safe environment for all athletes and treats all incidents relating to behaviour of this nature very seriously. We encourage all athletes and families to speak with gym management immediately upon experiencing any behaviour by an athlete, coach or other family member that may be construed as bullying, harassment or sexual misconduct. We will investigate in a sensitive and confidential manner, respectful for all concerned.
    24. Inability or refusal to follow these and other coach directives and rules WILL result in immediate expulsion from the gym.

I have read and fully understand this release, waiver, indemnity and authorization and have had the opportunity to ask questions and have them answered. I am aware that by signing this release, waiver, indemnity and authorization, I am giving up certain rights which I, my child, the Participant or my Successors may have against Perfect Storm.

 

First Athlete's Name

First Name*

Last Name*

Phone*
First Athlete's Date of Birth*
First Athlete's Information
Please select your gym location.*
First Athlete's Signature*
Second Athlete's Name

First Name*

Last Name*
Second Athlete's Date of Birth*
Second Athlete's Information
Please select your gym location.*
Third Athlete's Name

First Name*

Last Name*
Third Athlete's Date of Birth*
Third Athlete's Information
Please select your gym location.*
Fourth Athlete's Name

First Name*

Last Name*
Fourth Athlete's Date of Birth*
Fourth Athlete's Information
Please select your gym location.*
Fifth Athlete's Name

First Name*

Last Name*
Fifth Athlete's Date of Birth*
Fifth Athlete's Information
Please select your gym location.*
Sixth Athlete's Name

First Name*

Last Name*
Sixth Athlete's Date of Birth*
Sixth Athlete's Information
Please select your gym location.*
Seventh Athlete's Name

First Name*

Last Name*
Seventh Athlete's Date of Birth*
Seventh Athlete's Information
Please select your gym location.*
Eighth Athlete's Name

First Name*

Last Name*
Eighth Athlete's Date of Birth*
Eighth Athlete's Information
Please select your gym location.*
Ninth Athlete's Name

First Name*

Last Name*
Ninth Athlete's Date of Birth*
Ninth Athlete's Information
Please select your gym location.*
Tenth Athlete's Name

First Name*

Last Name*
Tenth Athlete's Date of Birth*
Tenth Athlete's Information
Please select your gym location.*
Athlete'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*
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.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Please select your gym location.*
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. You will receive an electronic copy of this waiver to the e-mail address provided.


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