The child(ren) participating at AGA Northwest have my permission to attend American Gymnastics Academy Northwest (AGA NW). I understand there is an element of risk involved in learning gymnastics including serious injury or death. I confirm that my child is in good health and that he/she has passed a physical examination by a doctor in the past 6 months. I promise I have read and understand the "Signs and Symptoms" checklist. I agree to taking my child's temperature prior to class. Should my child have a temperature that exceeds 100 degrees, I will not bring them to AGA Northwest. I give my permission for AGA NW officials to call a doctor, and call the persons listed on the family registration form, in the event of an emergency. I will in no way hold AGA NW, its officials or staff members, responsible for any possible illness, accident, or injury which might occur in class training. Nor will AGA NW be held responsible for any illness, accident, or injury that might occur traveling to and from the AGA NW facility. By entering this facility, you are aware that you agree to fully accept all known and unknown risks, including the potential risk of exposure to respiratory illnesses such as the coronavirus (COVID-19). The coronavirus is primarily transmitted via exhaled respiratory droplets, most often through coughing and sneezing. These droplets can travel up to six feet and are more commonly transmitted between persons rather than from equipment to persons. Although we regularly sanitize our equipment and presently are using enhanced cleaning methods and enforcing social distancing in our facility, you understand that you may be exposed to the coronavirus or its symptoms through no fault of our own. Known coronavirus symptoms include fever, coughing, shortness of breath, pneumonia, kidney failure, and may include other symptoms, stroke or even death (collectively "Symptoms"). You understand and agree that you will hold us harmless and you will not hold us liable for any real or perceived Symptoms of COVID-19 or any other disease, illness, or condition, nor for exacerbating any existing symptoms, and you fully agree to accept all risks of entering the facility, usingthe equipment, working with personal trainers, attending classes, and/or interacting or being exposed to other members. I do hereby authorize and consent to any x-ray, examination, anesthetic, medical or surgical diagnosis rendered under the general or special supervision of any member of the medical staff licensed under the provisions of the Medicine Practice Act or a dentist licensed under the Dental Practice Act and on the staff of any acute general hospital from the State of Washington. It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required but is given to provide authority and power to render care which the aforementioned physician in the exercise of his best judgment may deem advisable. It is understood that effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached. I understand and will comply with AGA Northwest’s Program Guidelines and Policies. I also understand these guidelines are posted in the facility and I will be emailed a copy of these guidelines upon class registration. I herby give my permission for images of my child to be used for the sole purpose for AGANW promotional and marketing materials. I understand the last name of my child will not be posted. I understand my child's trial class is a $10 fee. This fee will be applied to my account as a credit, should I enroll my child. I understand AGA Northwest must have a card on file at all times during my child's participation in the program. AGA Northwest will not use my card without verbal or written authorization. I understand AGANW will unenroll my card from the billing profile should I choose to not participate in the program. I understand, there is a $40 enrollment fee (unpon registration) as well as my monthly tuition. Monthly tuition is due on the 1st of each month. The card I'm providing will be used to fulfill my financial obligation. I understand that if my bill is not paid by the 5th, a late fee of 10% of the owed amount will be added to my account. I understand I am responsible to inform AGA Northwest by the 20th of the month prior if I wish to discontinue their program. Should I not inform AGANW of our dis-enrollment by the 20th of the month, I will be charged for the following month's tuition. I understand it is my responsibility to check my monthly charges through the parent portal or request them with the office personel. I understand there are absolutley no refunds given after tuition has been processed. AGA is a year-round program in which 12 monthly payments are made, starting at the time of enrollment. I understand I have the option to pay our fees in full, quarterly, or monthly. |