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Olympia Gymnastics Academy
51676 Danview Technology Ct.
Shelby Twp., MI 48315

WAIVER OF LIABILITY, CONSENT FOR MEDICAL TREATMENT, AND INDEMNITY AGREEMENT

In consideration of the benefits to be derived from participation in the gymnastics activities offered by Olympia Gymnastics, Inc., dba “Olympia Gymnastics Academy (OGA Inc.)” and with the understanding that participation is only on condition that I enter this agreement, the Parents or Guardians and the child/children named, I agree to the following Waiver of Liability, Consent for Medical Treatment and Indemnity Agreement.

The parent(s) and/or legal guardians will instruct the minor participant that prior to participating in the gymnastics activities described below he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate.  I understand and agree that, if at any time, I feel anything to be UNSAFE, I will immediately take all precautions to avoid the unsafe area and refuse to participate further.

I Agree

VIRUS WAIVER

I understand the contagious nature of certain bacteria and viruses, including Covid-19, and voluntarily assume the risk that my child(ren) and I may be exposed or infection may result in personal injury, illness, permanent disability or death. I understand that the risk of becoming exposed to or infected by Covid-19 at Olympia Gymnastics Academy (OGA) may result from the actions, omissions, or negligence of myself and others, including, but not limited to, OGA’s employees, volunteers, and program participants and their families. I VOLUNTARILY AGREE TO ASSUME ALL OF THE FORGOING RISKS AND ACCEPT SOLE RESPONSIBILITY for any injury to my child(ren) or myself (including, but no limited to personal injury, disability, and death), illness, damage, loss claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s or my attendance at OGA or participation in Olympia Gymnastics Academy’s programming.

I Agree

PERSONAL INJURY

1)    I fully understand and acknowledge that gymnastics is a vigorous, challenging, and DANGEROUS activity involving heights and balance, and as such it poses a risk of serious injury.
2)    I understand that injuries from participation in gymnastics activities may include, but are not limited to, injury to internal organs, bones, ligaments, tendons, muscles, and other parts of the body and could result in partial or total paralysis and even death.
3)    I understand that there may be other risks that are not known or are not reasonably foreseeable at this time.
4)    I understand that injuries received may be compounded or increased by rescue operations or procedures of OGA, Inc. staff.
5)    I understand that participation in gymnastics activities also includes activities incidental to participation, including moving from event to event, conditioning, stretching, and other activities which may render the participant vulnerable to other participants who may not have control over their actions during flipping, rotating, or running, and may not see other participants in the area.
6)    I understand that participation in gymnastics activities includes, but is not limited to, the use of gymnastics training and competitive apparatus, meets, exhibitions, games, and service projects, indoors and out, both official and unofficial.
7)    I understand that such injuries could result in severe economic and social losses or damages.
8)   I understand that despite the use of mats, pits, and other safety equipment and the active participation or supervision of a coach or teacher, such injuries will NEVER be eliminated from participation in gymnastics.
9)   With a full understanding of the above, I agree that I am voluntarily participating in this activity with the knowledge of the risks involved and hereby freely and expressly agree to accept all risks. I hereby release and covenant not to sue OLYMPIA GYMNASTICS, Inc. for any personal injury or wrongful death arising out of participation in its gymnastics activities however caused and whether caused in whole or in part by negligence attributable to OGA, Inc. I hereby voluntarily waive all claims, both present and future, made by me, my family, estate, heirs, or assigns.

I Agree

LOSS OF PROPERTY

1)   OGA, Inc. is not responsible for any injury or loss of property, to any person while participating in gymnastics activities for any reason whatsoever, including ordinary negligence on the part of OGA, Inc., its owners, employees, officers, contractors, agents, or other participants.

I Agree

ADVERTISING AUTHORIZATION

1)   I hereby authorize OGA, Inc. to use photographs for any purpose of publicity, illustration, commercial art, or in the advertising of any service or product of OGA, Inc.

I Agree

INTERPRETATION, INDEMNITY, AND CONSENT

1)    I understand that this Waiver Consent and Indemnity Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Michigan, and agree that if any portion is held invalid, the remainder of the Waiver Consent and Indemnity Agreement will continue in full force and effect.
2)    I agree to indemnify and hold harmless OGA, Inc. and all others listed for any and all claims arising as a result of participation in gymnastics activities, or any activities incidental thereto, wherever, whenever, and however the same may occur.
3)    I affirm that I have read and fully understood this Waiver Consent and Indemnity Agreement, understand that I have given up substantial rights by signing it, and have signed it freely and voluntarily without any inducement, assurance, or guarantee being made to me, and intend my signature to indicate consent to complete and unconditional release of all liability to the greatest extent allowed by law.

I Agree

December 8, 2022

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
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*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Birthday party Host

Last name of Party Host? *
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 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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