Loading...

Release of Liability Waiver

 

 

Release of Liability Waiver

In consideration of Rebound West Gymnastics allowing the gymnast to participate in sports activity, class, competition, team, including non-gymnastics activities such as dance, cheerleading and playground activities (hereinafter referred to as the “Activity”), I, and if I am not yet 18 years old my parents or legal guardians, agree to bound as follows (the term “I” in the release refers to both the gymnast and his or her parents or legal guardians):

(1) Acknowledgment and Assumption of Risk. I understand that the activity involves risks of serious bodily injury, including permanent disability, paralysis, and death, which may be caused by the gymnasts actions or inactions, those of others participating in the activity, the conditions in which the activity takes place, the negligence of the “Released Parties” named below, or other causes. I further understand that there may be other risks either not known to me or not readily foreseeable at this time. I fully accept and assume all responsibility for losses, cost and damages that may result from the activity. I hereby give my approval of and consent to the gymnast’s participation in the activity. I assume all risks and hazards incidental to the activity and to transportation to and from the activity. 

I Agree

(2) Representation of Ability to Participate. I understand that nature of the activity, and I represent that the gymnast is qualified, in good health, and in proper physical condition to participate in the activity. Should I ever believe that any of the above representations have become untrue, or if I should ever believe that the activity is not safe or is no longer safe for the gymnast, then It will be my responsibility immediately to discontinue the gymnast’s participation in the activity.

I Agree

(3) Release. I hereby release, acquit, covenant not to sue, and forever discharge Rebound West Gymnastics , its owners, officers, administrators, employees, agents, volunteers, sponsors, advertisers, coaches and supervisors, and the owners or lessors of any facilities within which the activity is conducted, their respective agents and employees, and all other persons providing facilities or assisting in the conduct of the activity and in the transportation of participants to and from the activity (collectively the “Released Parties”) of and from any and all actions, causes of action, claims, demands, liability, losses or damages of whatever name or nature, including but not limited to those arising from or in any way related to the negligence of any of the Released Parties, that arise out of or are connected in any way to the gymnast’s participation in the activity and the transportation of the above named gymnast(s) to and from the activity (collectively the “Released Claims”)

I Agree

(4) Indemnification. I will defend, indemnify and hold harmless the Released Parties from (that is, to reimburse and be responsible for) any loss or damage, including but not limited to costs and reasonable attorney’s fees (including the cost of any claim I might make or that might be made on my behalf or the gymnast’s behalf that is released in this document), arising out of or connected in any way with any of the Released Claims.

I Agree

I have read the Policies and Procedures for parents, spectators, and participants in the activity and/or the Team Handbook, and agree to abide by all rules and conditions set forth therein and to accept the judgment of the program officials in this regard.

Photo Release

I hereby grant permission to Rebound West Gymnastics to use my child’s image in any form of media, including print, internet and television for advertisement and promotional purposes. 

I Agree
 

General Rules

- Everyone is responsible for their own safety

- Place all personal belongings not in use in the cubbies provided. Rebound West is not respoinsible for lost and/or damaged items 

- We have a zero tolerance for bullying, verbal or physical abuse to all participants and/or Rebound West staff members

When jumping in the foam pit, you MUST land on your feet or bottom.  Diving is not permitted

1 participant on the trampoline at all times

- 1 participant on the tumble track at all times

- 1 participant on the equipment at all times

- Swinging on the ropes is not permitted

- No food or beverages allowed in the gymnastics area

- No jewlery may be worn in the gymnastics area

- No hats may be worn in the gymnastics area

- All long hair MUST be tied back

- Any questions or concerns, please see a Rebound West staff member for assistance 

I Agree

I HAVE READ AND UNDERSTOOD THIS ACKNOWLEDGEMENT AND ASSUMPTION OF RISKS, REPRESENTATION OF ABILITY TO PARTICIPATE, RELEASE, INDEMNIFICATION, AND CUSTODIAL PARENTS. I UNDERSTAND THAT BY SIGNING THIS DOCUMENT I AM GIVING UP SUBSTANTIAL RIGHTS. I AM EXECUTING THIS DOCUMENT VOLUNTARILY AND WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE. 

I Agree

Date: April 5, 2020

First Student's Name

First Name*

Middle Name

Last Name*

Phone*
First Student's Date of Birth*
First Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
First Student's Signature*
Second Student's Name

First Name*

Middle Name

Last Name*
Second Student's Date of Birth*
Second Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Third Student's Name

First Name*

Middle Name

Last Name*
Third Student's Date of Birth*
Third Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Fourth Student's Name

First Name*

Middle Name

Last Name*
Fourth Student's Date of Birth*
Fourth Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Fifth Student's Name

First Name*

Middle Name

Last Name*
Fifth Student's Date of Birth*
Fifth Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Sixth Student's Name

First Name*

Middle Name

Last Name*
Sixth Student's Date of Birth*
Sixth Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Seventh Student's Name

First Name*

Middle Name

Last Name*
Seventh Student's Date of Birth*
Seventh Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Eighth Student's Name

First Name*

Middle Name

Last Name*
Eighth Student's Date of Birth*
Eighth Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Ninth Student's Name

First Name*

Middle Name

Last Name*
Ninth Student's Date of Birth*
Ninth Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Tenth Student's Name

First Name*

Middle Name

Last Name*
Tenth Student's Date of Birth*
Tenth Student's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
Student'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

Emergency Contact's Name*

Emergency Contact's Phone Number*
How did you hear about us? (please check all that apply)
Friend
Yelp
Facebook
Instagram
Internet
Post Card
Birthday Party
Drive By
Other

Please specify any of the above:
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Any Medical problems RGW should be aware of?*

If Yes, please describe below:
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