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JERSEY JETS GYMNASTICS, INC. LIABILITY, RELEASE and INJURY WARNING

IMPORTANT READ, UNDERSTAND THE FOLLOWING BEFORE SIGNING

RISK OF INJURY WARNING

In consideration of your child’s participation in activities at Jersey Jets Gymnastics, Inc: I state that I understand the nature of this activity and that the student(s) are qualified, in good health, and in proper physical condition to participate in this activity. I also acknowledge that if current conditions change and become unsafe I will immediately discontinue the participation of my child in the activity. Jersey Jets Gymnastics, Inc. is warning that GYMNASTICS, TRAMPOLINE AND TUMBLING HAS A RISK OF PHYSICAL INJURY THAT CANNOT BE ELIMINATED. Included are minor injuries and more serious such as broken bones and dislocations. The risk also includes catastrophic injuries such as permanent paralysis or even death from landing or falling onto the back, neck or head. I further understand that there are other risks either not known to me, or unforeseeable at this time. I fully accept and assume all responsibility for injuries, loss, damages, and costs incurred as a result of participation in this activity. 

RELEASE INFORMATION

As a participant or legally responsible person for the students(s) listed above, I recognize the serious risk in gymnastics, trampoline and tumbling. I assume all responsibility for the student(s) listed above and release Jersey Jets Gymnastics, Inc. and all employees from losses resulting from participation in activities sponsored by Jersey Jets Gymnastics, Inc. This also certifies that the students(s) are physically able to participate in vigorous physical activity and competitive sport. 

SAFETY INFORMATION

All students must be picked up promptly at the end of class. If children are required to wait for your arrival they must not leave the building. Please plan to stay with young children during their class. If you do need to leave your child during their class make sure they know and that the desk has your cell phone number and are aware you will be gone. If you will be late for pick up of your child please make sure to call the gym so we can inform your child, and tell them they should wait in the lobby until you arrive. (856) 273-2822. 

ENROLLMENT

By signing below, you agree to abide by the Enrollment, Payment, and Attendance Policies of Jersey Jets Gymnastics. After your trial class (or initial Season placement for current customers), enrollment must be confirmed and accepted before attending the first class. Once confirmed/accepted, you are enrolled and your spot is held September through June for the School Year. You must complete the Summer Enrollment Form to be considered enrolled for July and August. If for any reason you wish to drop your child’s class during the year, a drop class form must be completed a week prior to your last class. Registration and drop forms can be found at the front desk and on the website.

You agree to make tuition payments by the first class of each month, and no later than the 15th of each month to remain enrolled in our program. If not paid by the 15th of the month, your contract will be terminated without further notice.

You must inform the front desk of any absences to be eligible to use make-ups for paid classes. If your child is called out, you may schedule a make-up within 90 days of the absence. If not called out, we will deny your make-ups for paid classes as we were not able to use your spot for another child to make-up.

 


Date: December 12, 2018

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Medical Information

Asthma, allergies, previous injuries, etc.
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Medical Information

Asthma, allergies, previous injuries, etc.
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Medical Information

Asthma, allergies, previous injuries, etc.
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
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Photo Release
Class requested (does not guarantee enrollment)

Student's Name

Class Title(s)

Day(s)

Time(s)
Please Select School Year or Summer *
School Year 18-19 (September-June)
Summer (July and August)
Second Student's Class Request (does not guarantee enrollment)

Student's Name

Class Title(s)

Day(s)

Time(s)
Please Select Summer or School Year
Summer
School Year 18-19
Third Student's Class Request (Does not guarantee enrollment)

Student's Name

Class Title(s)

Day(s)

Time(s)
Please Select Summer or School Year
Summer
School Year 18-19
Parent Contact Information

First and Last Name *

Phone Number *

Cell Phone Carrier *

Relationship to participant *
Secondary Contact Information

First and Last Name *

Phone Number *

Email Address *

Relationship to Student *
Medical Insurance: (Medical insurance is required for participation.)

Medical Insurance Carrier: *
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*
Parent or Guardian's Date of Birth*
Parent or Guardian's Medical Information

Asthma, allergies, previous injuries, etc.
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.


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