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WELCOME TO SPOKANE AERIAL PERFORMANCE ARTS!

Please carefully read and sign or initial where indicated. This waiver is required of all students and must be completed prior to the first day of class.  

Please feel free to call or email us at 509-435-1576 or spokaneaerial@comcast.net, if you have any questions.

 

Welcome to Spokane Aerial Performance Arts and congratulations on beginning your training program with us.  We are delighted you chose us as a part of your commitment to health, fitness and the arts!  With the help of your instructor and trainer, you will begin to accomplish your goals in an enjoyable, artistic and safe setting.

The following information will provide you with important program policies. Please read and sign this form to acknowledge that you have read and understand the following information.

COVID-19

In consideration of the services of Spokane Aerial Performance Arts, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “Spokane Aerial”), myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:

I represent that I am in good health and have no known exposure to COVID-19 and no symptoms of Covid-19, including fever, sudden loss of taste or smell, vomiting or diarrhea, cough, shortness of breath or sore throat, for 14 days prior to attending the facility.  I acknowledge that if I believe I have had any exposure to COVID-19, I will immediately cease attendance at the facility until I can again warrant that I have no known exposure for the 14-day period and alert the facility if I have been on the premises since my exposure.


I acknowledge that my participation in aerial and other classes or activities at Spokane Aerials’ studio or elsewhere entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, transfer of illness, or damage to myself, to property, or to third parties.  I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.  The risks include, among other things: slips and falls; falling from equipment; rope burns; pinches, scrapes, twists and jolts that could result in scratches, bruises, sprains, lacerations, fractures, concussions, or even more severe life threatening hazards; strains, cuts, bruises, muscle soreness and fractures; musculoskeletal injuries including head, neck, and back; injuries to internal organs; the negligence of other people; the negligence of other participants, or other persons who may be present; my own physical condition; and the risk of emotional and psychological insures or physical damage associated with this activity.  Traveling to and from shows, meets and exhibitions raises the possibility of any manner of transportation accidents.


I am aware that training during and after the COVID-19 pandemic involves certain inherent risks, dangers and hazards, which can result in serious infection, personal injury or death.  I further acknowledge, understand, appreciate, and agree that my participation may result in possible exposure to and illness from COVID-19.  While protocols and personal discipline may reduce this risk, the risk of serious injury, illness and even death is not possible to fully mitigate.


Furthermore, Spokane Aerial instructors and teaching assistants have difficult jobs to perform.  They seek safety, but they are not infallible.  They might be unaware of a participant’s fitness, abilities or potential communicable diseases.  They might misjudge the weather or other environmental conditions.  They may give incomplete warnings or instructions, and the equipment being used might malfunction.


Spokane Aerial is making its best efforts to reduce the risk of transmission of COVID-19.  But the safety of the community is in the hands of every one of us.  I expressly agree and promise to abide by the safety precautions displayed at the gym/studio, covered in pre-class safety briefings, displayed on the Spokane Aerial website, and communicated to me via email.


I expressly agree and promise to accept and assume all the risks existing in this activity.  My participation in this activity is purely voluntary, and I elect to participate despite the risks.


I hereby freely agree, to assume and accept all known and unknown risks of exposure to COVID-19, even arising from the negligence as a general principle on law, when a person knows of the risk of an activity, of the releasees or others and assume full responsibility for my participation.  I further recognize and acknowledge that the risks inherent in training can be greatly reduced by carefully following the safety precautions displayed at the gym/studio, covered in pre-class safety briefings, displayed on the Spokane Aerial website, and communicated to me via email.


I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Spokane Aerial from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Spokane Aerial’s equipment or facilities, including any such claims which allege negligent acts or omissions of Spokane Aerial.


I have read this Agreement and I fully understand its terms.  I understand that I am giving up substantial rights, including my right to sue the facility and its staff for injuries resulting from the inherent risks of training during and after the COVID-10 pandemic, and the ordinary negligence of the facility and staff.  I further acknowledge that I am signing this agreement freely and voluntarily, without inducement or assurance of any nature, and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by the laws of the State of Washington.

January 22, 2021

RELEASE FROM LIABILITY AND INDEMNITY AGREEMENT, PERMISSION TO TREAT IN AN EMERGENCY.

I acknowledge that my participation in aerial and other classes or activities at Spokane Aerials’ studio or elsewhere entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, transfer of illness, or damage to myself, to property, or to third parties.  I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.  The risks include, among other things: slips and falls; falling from equipment; rope burns; pinches, scrapes, twists and jolts that could result in scratches, bruises, sprains, lacerations, fractures, concussions, or even more severe life threatening hazards; strains, cuts, bruises, muscle soreness and fractures; musculoskeletal injuries including head, neck, and back; injuries to internal organs; the negligence of other people; the negligence of other participants, or other persons who may be present; my own physical condition; and the risk of emotional and psychological insures or physical damage associated with this activity.  Traveling to and from shows, meets and exhibitions raises the possibility of any manner of transportation accidents.


Knowing these risks, myself/my child(ren) assume all risks, whether foreseen or unforeseen, in connection with myself or my child participation in this activity. WE AGREE TO DEFEND, INDEMNIFY, HOLD HARMLESS, WAIVE, AND RELEASE SPOKANE AERIAL, TOGETHER WITH ITS OFFICERS, TRUSTEES, EMPLOYEES, AGENTS AND MEMBERS, AGAINST ANY AND ALL LIABILITY, CLAIMS AND CAUSES OF ACTION ARISING OUT OF, OR IN ANY WAY CONNECTED WITH MY CHILD'S PARTICIPATION IN THIS ACTIVITY. Furthermore, I assume complete responsibility for any property damage and/or personal injury caused by myself or my child(ren) in connection with my/his/her/their participation in activities at Spokane Aerial.


January 22, 2021

I assert that myself/my child(ren) has/have no physical condition that would prevent or hinder my/his/her/their participation, other than those disclosed. In the event of any injury, I authorize Spokane Aerial and its employees to administer first aid, transport myself/my child(ren) to a hospital, initiate medical treatment until I can be notified or my emergency contact can be notified.


I understand that this Release Agreement is a legally binding contract and shall remain in effect for the duration of myself/my child(ren)'s participation in Spokane Aerial activities. This Release agreement shall bind my heirs, personal representatives, assigns and all members of my family, including minors.


Payment Procedures: Tuition and annual membership fee is due at registration.  Once enrolled “all sales are final” and Spokane Aerial does not offer refunds or credits for any reason.


REGISTRATION AND STUDIO/GYM POLICIES

Commitment:  By registering and signing this form, you, as the student, are making a commitment to your health.  Please do your very best to attend every class of your session or agreement.  Keeping your commitment will help you to reach your fitness and artistic goals in the gym, Spokane Aerial Performance Arts.

Punctuality:  Students must be ready to train at the time specified.  Students shall also be attired as discussed below.  Since warm up time is essential for your safety, students arriving more than 10 minutes late for class will not be admitted to class. 

Attire:  Students must wear comfortable workout attire, including, but not limited to, clean t-shirts, athletic shorts, leotards, and tights.  Please no tank gops or sleeveless shirts and loose clothing may get in the way.  No clothing with zippers, buttons, hooks or safety pins.  Athletic shoes will not be worn during training (no shoes or socks are worn during classes).  Please feel free to ask the instructor for advice on what type of clothing and shoes is appropriate.

Jewelry:  Jewelry is NOT allowed.  Earrings, nose rings, belly rings and any other piercing is not allowed and must be removed prior to the start of class.  Rings and necklaces must be removed prior to the start of class.  Students will not be allowed to participate in silk classes with new piercings that cannot be removed.  No exceptions.  Class payments are not refundable for any reason and a credit will not be issued if students get new piercings during a session. Students will be asked to come back the next week if fingernails are too long or if jewelry cannot be removed.

Stopping Exercises:  Any student may stop any exercise for any reason (this is supported in every class for every student), using common sense and safety.  It is the student’s responsibility to notify the instructor of any discomfort or pain arising from or during exercise, as well as, any and all other known limitations the student has or experiences so that the instructor may accommodate the student and substitute another exercise to work that particular muscle group.  Although students are attending the aerial conditioning class with other students, individual adaptations can easily be made for different levels of fitness and strength.

Student Responsibility:  Students are responsible for undue damage done to equipment at Spokane Aerial.  Spokane Aerial does not accept responsibility for lost or stolen items.  Please leave your valuables at home.

Payment:  Payment is required in advance of the Session.  Online registration and payment are available.  It is the STUDENT’S RESPONSIBILITY to register and pay in advance in order to reserve his/her place in the upcoming session and class.  THERE ARE NO REFUNDS OFFERED AFTER YOUR REGISTRATION AND PAYMENT ARE RECEIVED FOR ANY REASON. THIS INCLUDES BUT IS NOT LIMITED TO ILLNESS, INJURY, JOB CHANGE, CHANGE OF ADDRESS OR MOVING, GETTING NEW PIERCINGS, NOT READING THE REGISTRATION FORM CAREFULLY, NOT LIKING THE LOCATION, OR ANY OTHER REASON.


Medical Coverage: I submit that I/my dependent or family member, am/are covered by medical insurance.  Please provide insurance company name and number when asked during registration.

Missing a Class:  No make up sessions are available for classes missed. 

I understand and agree with the above paragraph, REGISTRATION AND STUDIO/GYM POLICIES.  I also understand that payment is due at the time of registration, all payments are final and no refunds will be issued for illness, injury, relocation or any other reason except the COVID-19 restrictions that may come into effect from time to time. I also understand and agree that classes cannot be switched or moved once payment is received. I have carefully considered this and accurately completed my registration form, carefully selected my classes and understand my payment is non-refundable and non-transferrable for any reason.

I Agree
January 22, 2021

I HAVE FULLY INFORMED MYSELF OF CONTENTS OF THIS APPLICATION AND RELEASE FROM LIABILITY AND INDEMNITY AGREEMENT BY READING BEFORE SIGNING IT.

January 22, 2021

Please select who will be participating at Spokane Aerial Performance Arts
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First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
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.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Insurance

Insurance Carrier*

Insurance Policy Number*
Release from Liability and Indemnity Agreement
Participant Agreement, Release from Liability and Assumption of Risk. In consideration of the services of Spokane Aerial Performance Arts LLC, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "SAPA"), I hereby agree to release, indemnify, and discharge SAPA, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representatives and estate as follows: I acknowledge that my participation in circus arts training and instruction and other various disciplines entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: slips and falls; falling from equipment; rope burns; pinches, scrapes, twists and jolts that could result in scratches, bruises, sprains, lacerations, fractures, concussions, or even more severe life threatening hazards; strains, cuts, bruises, muscle soreness and fractures; musculoskeletal injuries including head, neck, and back; injuries to internal organs; the negligence of other people; my own physical condition; and the risk of emotional and psychological injuries or physical damage associated with this activity. Traveling to and from shows, meets and exhibitions raises the possibility of any manner of transportation accidents. In any event, if you or your child is injured, you or your child may require medical assistance, at your own expense. Furthermore, SAPA employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They might misjudge the weather or environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless SAPA from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of SAPA's equipment or facilities, including any such claims which allege negligent acts or omissions of SAPA. Should SAPA or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. In the event that I file a lawsuit against SAPA, I agree to do so solely in the state of Washington, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect. I understand that this Release Agreement is a legally binding contract and shall remain in effect for the duration of my or my children's participation in Spokane Aerial Performance Art's activities. This Release agreement shall bind my heirs, personal representatives, assigns and all members of my family, including minors. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against SAPA on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. *
YES, I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS RELEASE FROM LIABILITY AND INDEMNITY AGREEMENT BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE
Payment Policies
All payments are due prior to the first day of the session. Payments for classes are processed automatically each day. Be aware that any registrations not paid at the time of registration will be canceled and you will lose your space in class. I represent and warrant that if I am purchasing something from this facility or from Merchants that (i) any credit or bank account draft (ACH Draft) information I supply is true and complete, (ii) charges incurred by me will be honored by my credit card company or financial institution, and (iii) I will pay the charges incurred by me at the posted prices, including any applicable taxes, fees, and penalties. I hereby authorize (if online payment is made or autopay information is provided) this facility to charge my bank, or credit card account. I understand that a 30 day written notice is required to terminate billing and I am responsible for payment whether or not my student attends classes until I notify this facility in writing to drop my student from classes. Should I dispute a charge through my financial institution this will constitute a breach of contract possibly resulting in, but not limited to, penalties, additional fees, collection, legal action, and/or termination of any and/or all current and future service. *
YES, I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE PAYMENT POLICIES BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Rules, Terms and Conditions
I accept that Spokane Aerial Performance Arts offers NO REFUNDS, except in the event of class closure initiated by Spokane Aerial Performance Arts. Spokane Aerial Performance Arts offers no refunds in the case of a local or national disaster. The gym floor and equipment are to be used DURING CLASS TIME ONLY UNDER THE SUPERVISION OF A SPOKANE AERIAL PERFORMANCE ARTS INSTRUCTOR ONLY. Absolutely NO-ONE is allowed on the main gym floors, trampolines, or other equipment at any time outside of or between classes, regardless of age, level of physical fitness or experience, or student tenure at Spokane Aerial Performance Arts. Listening, paying attention, following instructor directions and safety rules will help you and/or your child get the most out of your Spokane Aerial Performance Arts class. Disruptive behavior can be dangerous and is not tolerated. If a student continues to exhibit disruptive behavior after repeated warnings and timeouts, instructor may ask the child to sit out the remainder of a class. It is helpful if parents can help reinforce the importance of paying attention and following directions in class. ADULT students are likewise expected to follow all instructor directives and may also be asked to leave class if any behavior or activities are deemed unsafe or disruptive by the instructor. Consumption of drugs or alcohol prior to participation in class is highly unsafe and students under the influence of either will be immediately ejected from class, with no refund or make-up given for the missed class. *
I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE RULES, TERMS AND CONDITIONS BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Safety
Students may not chew gum or have food on the gym floor Students and guests are not allowed on the gym floor before or after class and must always stay off of the equipment unless supervised by a instructor. Be on time for class! Missing the warm up may be a hazard. Students who are less than 10 minutes late will be instructed to complete the necessary warm up before participation can take place and may have to miss out on certain activities if a warm up in the gym is not done. Disruptive behavior will not be tolerated. Spokane Aerial Performance Arts reserves the right to cancel a student's enrollment at any time. Parents are allowed in designated waiting area only. ONLY students and instructor are allowed on the gym floor. Please park in designated spaces only. No horseplay at any time in the facility or on the grounds. *
I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE SAFETY RULES BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Arrival, Observation and Departure
Warm up time is essential for your safety; please plan to arrive on time. Students (adult & children) arriving more than 10 min late for class may not be admitted to class. Shoes, coats, and extra clothing will be placed in a cubbie after the instructor leads the students in a group to the silk area. Do not bring valuables to class. All students should remain at the chairs near the entrance until their instructor comes to get them and lead the entire group to the silk area. Parents please pick students up promptly after their class is completed. Students (children and/or minors) are not allowed to leave the building except with a parent or other responsible adult. Parents you MUST come inside to pick up your child. Due to COVID-19, please do not bring family members to the gym to watch the class. There is a limited number of chairs and limited space due to social distancing regulations. *
I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE ARRIVAL, OBSERVATION AND DEPARTURE SECTION BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Makeup Classes
NO MAKEUP CLASSES ARE AVAILABLE FOR ANY REASON. Spokane Aerial does not offer credits, transfers or refunds. Spokane Aerial does not refund for illness or injury. Missed classes will not result in prorated tuition or refund, and do not carry over between Sessions. Occasional missed classes are acceptable but cannot be made up or prorated. *
I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE POLICIES FOR MAKEUP CLASSES BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Jewelry and Attire Policies
Student must dress appropriately. For males, T-shirt & athletic shorts. For females, leotards and/or leggings with t-shirt. Most fitness/athletic clothing without strings, buttons, zippers or other restrictive are also acceptable. NO JEANS! Bare feet are recommended. Footed tights are not allowed. Jewelry is NOT allowed. Rings, toe rings, earrings, nose rings, belly rings, and any other piercing is not allowed and must be removed prior to the start of class. Rings and necklaces must be removed prior to the start of class. Do NOT bring valuables to class. Spokane Aerial Performance Arts is not responsible for the loss of personal items. Students must have hair tied back away from his/her face. Students must wear a headband to secure their glasses, if applicable. *
I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE JEWELRY AND ATTIRE POLICIES BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Personal Hygiene
Students cannot have long fingernails or toenails for silk or lyra classes. All nails should be even with the end of the finger or toe without any sharp edges. Long fingernails or toenails will have to be cut and filed smooth before students will be allowed to participate in class. This includes children's classes. Please come to class with clean garments and no perfume or scented lotions. The aerial silk apparatus' are used by others and smells tend to "stick" to the silk. Shirts with sleeves are best for hygiene and also to prevent burns in the arm pit area when sliding down the silks. Please do not come to class when you are sick. Viruses and flus are easily spread in our setting. Feel free to email Spokane Aerial if you have questions about this. *
I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE PERSONAL HYGIENE POLICY BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Equipment
Student may be responsible for the replacement of equipment (silks) if they are the cause of damage due to attire (see above). Rings, piercings, zippers and other mentioned items above can cause ruin the silks by causing holes and tears. *
I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE EQUIPMENT USE POLICY BY READING THIS BEFORE SIGNING IT.
NO, I DO NOT AGREE.
Medical Information
********PLEASE READ THIS QUESTION CAREFULLY****** Does self/child have ANY medical or learning problems that will interfere with aerial and circus arts? *
YES
NO
I am the parent or legal guardian of the child(ren) identified in this waiver and I voluntarily authorize my child(ren) to participate in aerial activities at Spokane Aerial. *
Yes
No
N/A
Minimum Health Requirements
Basic I Level classes are designed for new students who may not have a lot of core or upper-body strength. All levels, ages, and body types are welcome. Students must be in good health to participate in such activity. Clients with the following physical limitations should consult their doctor before participating in aerial acrobatics: Pregnancy, glaucoma, recent surgery (esp. shoulder, eyes, back, hips, hands or wrist), heart disease, very high or low blood pressure, easy onset vertigo, osteoporosis / bone weakness, recent head injury, cerebral sclerosis, propensity for fainting, carpal tunnel syndrome, severe arthritis, sinusitis or head cold, hiatal hernia, disc herniation or acute, discogenic disease, recent stroke, artificial hips, radiculitis (inflammation of nerve root in spine), severe muscle spasms, botox injections (within 6 hours). *
I HAVE READ AND AGREE
NO, I DO NOT AGREE
Soreness and Stiffness
Aerial work is a highly intense fitness program. Expect to be sore after class. Soreness should last 2-3 days, and typically occurs in the fingers, forearms, back, and abs. If soreness lasts longer than 5 days, consider taking a break until completely healed. Even if new students are in good shape, as with any new movement practice, they will probably still experience soreness. Aerial work is a unique fitness program because it introduces the body to the instability of suspension. The body must strengthen all the tiny stabilizer muscles that don't normally get used. Expect to experience soreness regularly after class for about 4-6 weeks. Calluses are normal on the palms and fingers. *
I HAVE READ AND AGREE
I DO NOT AGREE
Physical Activity Readiness

If you check "yes" for any of the following questions, you must receive clearance from your physician prior to participating in this exercise program.  Please have your physician complete the "Physician Clearance" Form.  For a copy of the Physician Clearance Form, please email spokaneaerial@comcast.net. 

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *
YES
NO
Do you lose your balance because of dizziness or do you ever lose consciousness? *
YES
NO
Do you have a bone or joint problem (for example, back, hands, knee or hip) that could be made worse by change in your physical activity? *
YES
NO
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? *
YES
NO
I have read the above and have answered all of the questions to the best of my knowledge. *
YES, I AGREE, TO THE BEST OF MY ABILITY
NO, I DO NOT AGREE. ANSWERING SOMETHING VAGUELY OR INCORRECTLY MAY DISQUALIFY YOU FROM PARTICIPATION.
I fully and accurately completed the Medical Information section for the Spokane Aerial Performance Arts conditioning and performance program and have no physical condition that would prevent or hinder my participation, other than those disclosed. In the event of any injury or illness while attending SAPA, I authorize SAPA and its employees to administer first aid, initiate a call to first responders and initiate medical treatment if necessary. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS HEALTH QUESTIONAIRE BY READING THIS BEFORE SIGNING IT. *
YES, I HAVE READ AND AGREE
NO, I DO NOT AGREE. ANSWERING NO TO THIS QUESTION MAY DISQUALIFY YOU FROM PARTICIPATION
How did you find out about us?

Thank you! *
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 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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