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Welcome to Mayela Rhythmic season 2023-2024! 

Please complete the following waiver and registration form below.

Classes start on Sunday September 10, 2023

There is a $50 registration fee. You can make the registration fee payment together with your tuition payment or you can send it through Zelle using my cell number (850)274-1675. Please make sure to add a note with the students name if you send it through Zelle. 

You will receive more detailed information on your class as we approach the start of classes in September. 

Trial Classes and Open House Class (ages 5-12)

For trial classes, please complete the following waiver and registration form below and select Trial Class as your class option.

Thank you! 

REQUIRED POLICIES AND AGREEMENTS

Assumption of Risk

I understand that rhythmic gymnastic training from Mayela Rhythmic Gymnastics requires a sustained, repetitive amount of vigorous physical activity. It is also understood that rhythmic gymnastic instruction involves kinetic corrections that may include physically touching the student as a part of instructing. I understand that participants may engage in repetitive impact as well as a broad range of quick movements, bending, twisting, dropping, running, leaping and lifting, which place extreme demands on the human body, including the stress of joints and ligaments. I understand the possibilities of occasional falls, slips and collisions with other students and objects may occur as well.


I also understand that there are inherent risks of serious personal injury involved in all of the activities listed above and I voluntarily assume and accept such risk of personal injury and illnesses arising from my child's/ children's attendance at/ and or participation in the class.

 I've read the above and agree.

I Agree
  

Release of Liability

As the legal parent or guardian, I release and hold harmless Mayela Rhythmic, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Mayela Rhythmic, its owners and operators or in route to or from any of said premises. 


My child has my permission to participate in Mayela Rhythmic classes. I hereby acknowledge that I am the parent or legal guardian of the above named child and that the personal foregoing information in the registration form is correct. I agree to notify Mayela if there are any changes in the information supplied, or if any limitation should arise which would affect my child's participation in class. I understand that I can contact Mayela Rhythmic for any further information. It is my responsibility to keep current of class information by checking with my child and reading notices send by e-mail. It is also my responsibility to contact Mayela Rhythmic by e-mail to convey any information necessary, including updated personal information on my child.

 I've read the above and agree.

I Agree
  

 

Medical Emergencies

I, the legal parent/guardian give permission to Mayela Rhythmic, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian in case of an emergency. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health.

 I've read the above and agree.

I Agree
 

Photo and Video Release

I hereby authorize Mayela Rhythmic for all time to use photographs or video of students or former students for publicity or advertising purposes.

 I've read the above and agree.

I Agree
  

Expectations of students

A student may be withdrawn from a performance or class due to the following:

-being noticeably behind with the material learned in the rehearsals leading up to the performance.

-excessive absences from practices.

-due to offenses character or disciplinary offenses. This is taken very seriously at Mayela Rhythmic. Being disrespectful to a teacher and/or peers or the use of obscene language or physical altercations will not be tolerated.

 I've read the above and agree.

I Agree
  

 


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Select your class*

Additional Information
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Select your class*

Additional Information
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Select your class*

Additional Information
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Select your class*

Additional Information
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Select your class*

Additional Information
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Select your class*

Additional Information
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Select your class*

Additional Information
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Select your class*

Additional Information
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Select your class*

Additional Information
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Select your class*

Additional Information
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Select your class*

Additional Information
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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