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Rebound Gymnastics Waiver

Required Policies and Agreements

PARENTAL CONSENT AND RELEASE OF LIABILITY

In consideration of participating in any event or program at Rebound Gymnastics I, the minor's parent and/or legal guardian, understand the nature of this Activity and that the minor is qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in the activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the "releasees" named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost and damages I incur as a result of my participation in the Activity.

I hereby release, discharge, and covenant not to sue Rebound Gymnastics Inc., its respective administrators, directions, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners, and lessors of premises on which the Activity takes place, (each considered one of the "RELEASES" herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the "releasees" or otherwise, including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost, which any may incur as the result of such claim.

I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, not withstanding, shall continue in full force and effect.

I've read the above and agree. 

I Agree

 

COVID-19 LIABILITY RELEASE WAIVER

I am aware of the existence of the risk on my physical appearance to the venue and my participation in the activity at Rebound Gymnastics that may cause injury or illness such as, but not limited to Influenza, MRSA, or COVID-19 that may lead to sickness or death

I am fully and personally responsible for my own safety and actions while and during my participation and I recognize that I may be in any case, be at risk of contracting COVID-19

With full acknowledgement of the risks involved, I hereby release, waive, and discharge Rebound Gymnastics, its board, affiliates, employees, and assigns from any and all liabilities, claims out of or related to any loss, damage, injury, or death that may be sustained by me related to COVID-19 while participating in activity while in, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19

I agree to indemnify, defend, and hold harmless Rebound Gymnastics against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19

By signing below, I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed with full intention to be bound by the same and free from any inducement or representation.

This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted.

I've read the above and agree. 

I Agree

 

ILLNESSES

If your child has been sick in the past 24 hours, please do not bring them to the gym. If your child has had a fever, yellow-greenish mucus from their nose, vomited or had diarrhea in the past 24 hours then they need to stay away from other children. Please do not send sick siblings to the gym.

Children must be free from fever, without the aid of medication for a minimum of 24 hours before participating in class. As with any children's program keeping the children and staff healthy keeps us all happy!

I've read the above and agree. 

I Agree

 

MEDICAL CONSENT

The undersigned hereby further authorizes any of the staff, employees, agents, and representatives of Organizer to provide for, approve and authorize any health care at any hospital, emergency room, doctor's office or other institution; employ any physicians, dentists, nurses or other person whose services may be needed for such health care form required by medical, dental or other health authorities incident to the provision of medical, surgical or dental care to the Child. Health care may include but not be limited to, administration of anesthesia, X-ray examination, performance or operations, diagnostic and other procedures.

If there is no medical emergency, the staff will first use reasonable efforts to contact the parent(s) and/or guardian(s) before administering or authorizing any treatment. Notwithstanding other provisions in this Consent Form, Organizer shall not have the authority to withhold or withdraw life-sustaining procedures for the Child.

In case of medical emergency, I understand that my child will be transported to the facility/hospital that the local EMS/emergency resource deems necessary. I understand that I will be responsible for all medical and emergency costs including transportation expenses.

I hereby release, discharge, and covenant not to sue Rebound Gymnastics, Inc, its respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "Releasees" herein) from all liability, claims, demands, losses or damages, on my account caused or alleged to be caused in whole or in part by the negligence or strict liability of the "Releasees" or otherwise, including, without limitation, negligent rescue operation, and further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf or behalf of the Child, makes a claim against any of the Releasees, I will indemnify, defend, save and hold harmless each the Releasees from any loss, liability, damage, or cost, which may incur as the result of such claim. 

I've read the above and agree. 

I Agree

 

TUITION/LATE FEE AND PAYMENTS/FEES

Tuition is due by the 25th for the following month's tuition.  For example, May's tuition is due on April 25th.  Tuition payment that is not received by 11:59pm on the 25th will incur a late fee on the 26th.  Team late fee is $25 and recreation and tumbling class late fee is $10.

Accepted payments are cash, check, credit cards and the business Venmo account (@rebound_gym).  Accepted credit cards are Visa, AmEx, Master Card and Discover.  There will be a 3% fee for all credit card transactions (one time payment, auto payment and/or future online portal payments).  There will be a 2% Venmo fee, that needs to be calculated and to be included in the Venmo payment transaction.

I've read the above and agree. 

I Agree

 

AUTO PAYMENT

We strongly recommend setting up auto payment for your convenience as this will save you time and avoid late fees.  To ensure data security, the processing platform we utilize is in accordance with the PCI DSS and is a Level 1 PCI Compliant Service Provider.

The Primary Guardian listed on the account is considered the account holder and is responsible for any and all balances on that account.  I understand that my child’s tuition is due on the 25th of the prior month.  (For example, May's tuition is due on April 25th).  By selecting the Autopay option, my credit card will be charged on the 25th of the month for the following month's tuition, which will avoid a $25 (team)/$10 (recreational) late fee.  

If the auto payment section is completed, I hereby authorize you to collect tuition and any past due balances on my account from the credit card stated in this document.

I've read the above and agree. 

I Agree

 

PROGRAM DROP

If you are planning to leave the program for any reason for 1 month or longer or if your child will not be returning, please plan your departure accordingly and inform us of your withdrawal before the due date of the next billing cycle. You must fill out and submit a PROGRAM DROP FORM, by the 15th or your account will continue to be charged, including auto payments.  Please ask your coach or send a request email for the PROGRAM DROP FORM. 

We require a PROGRAM DROP FORM to be hand-delivered to a RGE staff member by the 15th of the preceding month.  (For example, if you are dropping the program for May 1st, we will need to receive this form by 5pm on April 15th.)  Any forms turned in after the 15th of a given month will be considered notice for the 1st of the subsequent month. (For example, if we receive a drop form on April 19th, you will be unenrolled as of June 1st.)  

I've read the above and agree. 

I Agree

 

REGISTRATION FEE

All participants will incur an annual registration fee.  The team registration/insurance fee is $100 due on June 1st, annually regardless of start/anniversary date.  The recreational and tumbling class registration is $45 due annually at start/anniversary date.

I've read the above and agree. 

I Agree

 

REFUND AND MAKE-UP POLICY

There are NO REFUNDS if your child decides to quit for any reason. 

There are NO REFUNDS for closing of the gym or cancelled practices due to inclement weather, severe weather, health crisis, pandemics, epidemics, national disasters, government mandates, or other unforeseen circumstances which are beyond our control.

For TEAM:

There are NO REFUNDS/ CREDITS on team and summer tuition.

There are NO REFUNDS for all deposits and commitment fees. When a member of the Rebound Gymnastics team commits to a competitive season, or a payment has been made into the commitment account, this binds you for a season. For example: If your account is paid in full, and you choose to remove your child from our program any time thereafter, we cannot grant a refund. No refunds will be given if you decide to leave. Commitment fees are assessed and based upon a budget calculated by the number of girls on the team.  

There are NO REFUNDS for meets that are cancelled due to inclement weather, severe weather, health crisis, pandemics, epidemics, national disasters, government mandates, or other unforeseen circumstances which are beyond our control.  

There are NO make-ups for time missed by a team athlete. 

For Recreational and Tumble Classes:

Make-ups can be done if there is a same class available and must be done within the month.

I've read the above and agree. 

I Agree

 

RESPONSIBILITIES

We make every effort to monitor children after classes. Parents need to be on time to pickup their children. Many children get very anxious when class is over and they don't see mom or dad.

If you will be later than 15 mintues after end time, a staff member of Rebound must be notified via email or other form of communication.

I've read the above and agree. 

I Agree

 

PHOTO/VIDEO RELEASE

Rebound Gymnastics has my permission to publicly use my child’s photograph/video for publicizing and promoting the gym's programs and services. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

I've read the above and agree. 

I Agree

 

INTEGRATION AGREEMENT

These policies and waivers contained herein supersede any and all prior practices, oral or written representations, or statements.  Rebound Gymnastics expressly revokes any and all previous policies and procedures which are inconsistent with those contained herein.

I've read the above and agree. 

I Agree

 

I Agree to All of the Above and that this Waiver Will Supersede Any and All Past Agreements 

I Agree

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
First Participant's Signature*
Second Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Third Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Fourth Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Fifth Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Sixth Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Seventh Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Eighth Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Ninth Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
Tenth Participant's Name

First Name*

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

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
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.
Family Information

Primary Parent/Guardian Name (First and Last Name) *

Primary Relationship *

Primary Mobile Number *

Primary Email Address *

Secondary Parent/Guardian Name (First and Last Name) *

Secondary Relationship *

Secondary Mobile Number *

Secondary Email Address *
Insurance Information

Insurance Carrier *

Insurance Policy Number *
Emergency Contacts (Not Primary or Secondary Parent/Guardian)

#1 Emergency Contact Name (First and Last Name) *

#1 Relationship *

#1 Mobile Number *

#2 Emergency Contact Name (First and Last Name) *

#2 Relationship *

#2 Mobile Number *
Referral Information

How did you hear about us? Referral name is applicable. *
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*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Primary Doctor *

Primary Doctor's Phone Number *
Does the participant have any food allergies, including peanut, tree nuts, etc.*
No
Yes

If yes, please explain.
Will you be bringing any medication to the gym that we will administer in case of an emergency, including epinephrine pen, etc.*
No
Yes

If yes, please explain.
Does the participant have any medical situations including current medications, dietary restrictions, and/or special needs?*
No
Yes

If YES, please explain.
Does the participant have any health situations including physical, psychological, learning and/or behavioral?*
No
Yes

If YES, please explain.
Does the participant have any past injuries, surgeries, recurring pain or chronic issues?*
No
Yes

If YES, please explain.

Auto Pay Credit Card Number

Credit Card Expiration Date

Credit Card Security Code (AMEX - 4 digit number in front / ALL OTHERS - 3 digit number in back)

Credit Card Billing Address
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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