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Agreement between Gleeson Sports Pty Limited (ACN 632 044 181) (Obstacle Course Racing School), you and the child.


Preliminary

A. Any reference to “Gleeson Sports” includes Gleeson Sports Pty Limited, its subsidiaries, its directors, partners, office holders, employees, agents, contractors, landlord, supervisors, successors, assigns, related entities and suppliers.

B. Any reference to the “Child” means any child or children engaging/participating in the activities and/or receiving the benefit of the services Gleeson Sport Offers under this agreement.

C. Any reference to “you” means yourself as a participant engaging/participating in the activities/receiving the benefit of the services that Gleeson Sport Offers under this agreement and/or as:

  • the parent of the child and/or
  • having parental responsibility for the child and/or
  • having the child under your control

Terms and Conditions

Fees

1. You agree to pay the fees of Gleeson Sports in advance of the supply of their services/in consideration for the services and activities offered by Gleeson Sports

Children participants

2. You acknowledge and declare you are the parent of the child and/or have parental responsibility for the child and/or the child is otherwise under your control and that you have the authority to enter into this agreement on behalf of yourself and the child.

Activities

3. The activities offered to you and/ or the child include but are not limited to:

3.1 Use of the following obstacles: 10ft Flat Wall, 8ft Flat Wall, Traverse Block Wall/Z Wall, Cannon balls, Candlesticks, Ring swing, Rope junction, Traverse rope, Swinging bridge, Stable & Unstable bridge, Trapeze bars, Monkey bars/A-Frame, Bungees, Baboon bars, Battering Ram, Ring Toss, Cliff Hanger, Rope Ladder, Peg board, Devil Steps, Floating doors, Under and overs, Bungees, Dancing bars, Rope climb, Tarzan swing, Mini tramp, 14ft Warped Wall, 10ft Warped Wall, 8ft Warped Wall, Olympus, A-Frame, Salmon Ladder, Cargo Net, Circuit Board , Bar slider , Ninja steps, Balance beams/logs, Rolling Logs, Rolling Reel, Stepping stones, Seesaw, Slack line, Jumping Spider, Rolling Dice, Lache Bars, Flying Bar, Olympus

3.2 Use of the following fitness items: Treadmills, Bikes, Rowers, Skiergs, Dumbbells, Kettlebells, Barbells, Medicine balls, Slam balls, Free forms, Fit balls, Skipping ropes, Bosu, Agility ladder, Battle ropes, Sleds, Torsion bars, Sandbags, Ab wheels, Hurdles, Resistance bands, Chin up bars, Dip bars, Push-up bars, Benches, Steps, Cables, Leg press, Leg Extension, Leg Curl, Squat Rack, Lat Pulldown, Cables, Boxing gloves/pads

3.3 Bucket carry, Tyre drag, Block drag, Spear throw, Farmer carry, Hercules Hoist

Warnings and waivers

4. You acknowledge that the services Gleeson Sports supply to you and/or the child are services supplied for the purposes of, in connection with or incidental to the pursuit of you/the child of recreational activities.

5. You acknowledge that the activities Gleeson Sports you and/or the child to participate in are recreational activities being a sport, activities and/or activities engaged in for enjoyment, recreation or leisure.

6. You acknowledge that you have requested and obtained information about what the activities/obstacles/fitness items are or involve from Gleeson Sports, and/or have had the opportunity of requesting and obtaining information about what the activities/obstacles/ fitness items are or involve from Gleeson Sports and that you have the opportunity of inspecting the obstacles/fitness items and determining which activities you and/or the child choose to participate in. You further acknowledge that you and/or the child are not obliged or required to engage in any activity Gleeson Sports offer and that you have been given the opportunity and continue to have the opportunity to advise and direct us (with such direction to be made in writing) which activities you do not authorise the child to be involved in, and are otherwise allowing you/the child to willingly and voluntarily participate in the activities.

7. You acknowledge that the activities Gleeson Sports offer you and/or the child (including the use of the obstacles and fitness items) involve the risk of property loss, injury and even death to you and/or the child, other participants, spectators and others. Such risks include (by way of examples of the general risks that exist) injury (including mental harm) incurred by: , lack of hydration, falling off or colliding with the obstacles or fitness items, uncontrolled landings, colliding with other participants or spectators, falling over while using the fitness items, dropping items on oneself or another person, tripping errors in judgment by an assisting instructor or and falling from the grip of an assisting instructor or other person

8. You further acknowledge that some or all of the activities Gleeson Sports offer you and/or the child (including the use of the obstacles and fitness items) involve an obvious risk and also carry an inherent risk of property loss, injury and even death to you and/or the child, other participants, spectators and others. Such risks include (by way of examples of the general risks that exist) injury (including mental harm) incurred by: lack of hydration, falling off or colliding with the obstacles or fitness items, uncontrolled landings, colliding with other participants or spectators, falling over while using the fitness items, dropping items on oneself or another person, tripping, errors in judgment by an assisting instructor or personnel and falling from the grip of an assisting instructor or other person.

9. You declare and certify that you and/or the child have no known or pre-existing physical or mental conditions that would affect his, her or your ability to safely engage in the activities, or that would result in their/your participation or engagement creating a risk of danger to others.

10. You acknowledge and agree that it is your responsibility to continuously monitor your own and/or child’s physical and mental condition during the activities and agree to withdraw yourself and/or the child immediately and to notify appropriate personnel if at any point your/their continued participation engagement would create a risk of danger to yourself/ themselves or to others.

11. To the extent permitted by law, you and/or the child engage in the activities Gleeson Sports offer to you and/or the child (including the use of the obstacles and fitness items) at your own risk and/or at the own risk of the child and that Gleeson Sports is not liable for any breach of an express or implied warranty that the services Gleeson Sports offer will be rendered with reasonable care or skill.

12. To the extent permitted by law, you hereby release, agree to hold harmless, defend, and indemnify (which for the avoidance of doubt includes the costs of defending and paying any judgment, court costs, investigation costs, legal fees, and any other expenses ) Gleeson Sports from any and all claims made by you and/or the child of whatsoever kind including any claim in tort, contract or at law.

13. To the extent permitted by law, you further release, agree to hold harmless, defend, and indemnify Gleeson Sports against any and all claims of whatsoever kind including any claim in tort, contract or at law of co-participants, rescuers, and others arising from your and/ or the child’s conduct in the course of participation/engagement in the activities or whilst present on or within the vicinity of the premises or location where the activities occur.

Discretion to exclude, filming of participants and miscellaneous

14. You acknowledge and agree that Gleeson Sports may at their absolute discretion require you and/or the child to immediately leave the premises or location where the activities occur, without liability for any claim by you or the child, in circumstances where in the opinion of Gleeson Sports the continuing presence of you and/ or the child is causing a nuisance or disturbance to others or is causing a safety concern to any persons, including you and/or the child.

15. You acknowledge that Gleeson Sports utilise Closed Circuit Television Cameras and consent to us filming you and/ or the child whilst on or within the vicinity of the premises or location where the activities occur.

16. This agreement contains the entire agreement between the parties with respect to its subject matter and supersedes all prior discussions, representations, agreements, warranties and understandings between the parties in connection with the subject matter.

17. This agreement is governed by and is to be interpreted according to the laws in force in New South Wales. The parties submit to the exclusive jurisdiction of the courts operating in New South Wales.

 

I agree to the above for and on behalf of myself and or on behalf the child/ children

 

I Agree

Today's Date: April 25, 2024


First Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

First Participant's Signature*
Second Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Third Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Fourth Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Fifth Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Sixth Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Seventh Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Eighth Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Ninth Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

Tenth Participant's Name

First Name*

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

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

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*
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*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Gender*

Pre Exercise Screening Questionnaire

Does your child play any sports?*

If so, please list:

Medical History

Does your child have any medical conditions or additional needs?*

If so, please list:
Does your child take any medications?*

If so, please list:
Does your child suffer from any allergies?*

If so, please list:
Does your child have any injuries, disabilities or medical conditions that may be made worse by physical exercise?*

If so, please list:

If you have answered "no" to all of the above questions and  the child has no other known or pre-existing physical or mental conditions that would affect their ability to safely engage in the  physical activities/ services we offer, or that would result in their participation or engagement creating a risk of danger to others, then the child may proceed to participate in the physical activities/ services we offer. You acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others. In such case you will also complete a new exercise pre-screening health questionnaire.

If you have answered "yes" to any of the above questions or are uncertain as to how to answer, we recommend you obtain a medical certificate from the child's medical practitioner/ specialist confirming the child is fit to participate in any or all of the physical activities/ services we offer or you. You also acknowledge and agree that it is your responsibility to continuously monitor the child's physical and mental condition during the activities and agree to withdraw the child immediately and to notify appropriate personnel if at any point their continued participation engagement would create a risk of danger or to others.

If there is any inconsistency between this document and the terms of our agreement, the terms of the agreement are to prevail.

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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