Kyle Shewfelt Gymnastics Participant Waiver

SCHEDULE “A” TO RELEASE AGREEMENT

TRAMPOLINE WAIVER

TRAMPOLINE RELEASE OF LIABILITY, WAIVER OF CLAIMS,

ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

(hereinafter referred to as the “Trampoline Release Agreement”)

BY SIGNING THIS DOCUMENT YOU WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS,
INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT

PLEASE READ CAREFULLY!

This Trampoline Release Agreement shall apply to all subsequent membership renewals.

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TO: The “Releasees”.
FROM: The Releasors

DESCRIPTION OF RISKS:

I am aware that, in addition to the inherent risks associated with the sport of gymnastics as are described in the Release Agreement to which I am a party along with the Releasees, there are additional inherent risks associated with the use of a trampoline. In particular, I understand that the use of a trampoline greatly increases the risk of serious personal injury that I /my child are exposed to as a result of my/my child’s presence at and my/my child’s use of gymnastics equipment on the Gymnastics Club’s premises and facilities. I understand this includes risk of negligence on the part of the Releasees, including the failure on the part of same to take reasonable steps to safeguard or protect the participants from the risks, dangers and hazards, both known and unknown, of participating in the SPORT OF TRAMPOLINE. I acknowledge that personal harm or injury may be sustained during my/my child’s involvement in the SPORT OF TRAMPOLINE, including, but not limited to, exposure to any contagious or infectious diseases transmitted or contracted through any means whatsoever, broken bones, head / neck injuries, concussion, dislocations, tendon and ligament damage (including sprains), damage to teeth and dental work, internal injuries, bruises, strains, lacerations, spinal injuries (that could result in various degrees of paralysis), brain injury and death. I acknowledge and assume the potential risks and consent to my/my child’s participation in the SPORT OF TRAMPOLINE.

CONSENT TO PARTICIPATION:

I/my child have/has been informed that I/he/she is to abide by the rules and regulations including directions and instructions from the administrators, instructors, coaches, and supervisors as imposed on me/my child while participating in the SPORT OF TRAMPOLINE.
I/my child confirm that I/my child have read the Trampoline Safety Rules posted on the website and around the Gymnastics Club’s facilities.
In the event that I/my child fails to abide by the rules and regulations imposed on me/my child while participating in the SPORT OF TRAMPOLINE, disciplinary action may either require that I/he/she not participate in the SPORT OF TRAMPOLINE, or that I will leave/be contacted to have my child picked up or transported home at my own expense.
I acknowledge that I/my child am/is in good health, and in proper physical condition to participate in the SPORT OF TRAMPOLINE, and I acknowledge it is my responsibility to notify the staff of any physical or mental concerns for me/my child which may affect my/my child’s participation in the SPORT OF TRAMPOLINE.
acknowledge that the SPORT OF TRAMPOLINE may require an instructor, coach, employee or supervisor to perform some manual spotting which involves direct physical contact with me/my child and designed to assist the participant in the safe performance of the program skills, and I consent to same.

RELEASE OF LIABILITY AND WAIVER OF CLAIMS:

I confirm that I have read the above description of risks and understand the risks involved in participating in the Gymnastics Club’s programs and the SPORT OF TRAMPOLINE. I confirm that I voluntarily and freely accept all such risks and choose to participate/allow my child to participate in the Gymnastics Club’s program and the SPORT OF TRAMPOLINE. I accept full responsibility for my own/my child’s actions.

In consideration of being allowed to participate in the Gymnastics Club’s programs and SPORT OF TRAMPOLINE, I hereby agree as follows:

TO WAIVE ANY AND ALL CLAIMS that I/my child have or may in the future have against THE RELEASEES, and TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury including death that I/my child may suffer, or that my next of kin or my child’s next of kin may suffer, as a result of my use/my child’s use of or my/my child’s participation in the SPORT OF TRAMPOLINE DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS' LIABILITY ACT, R.S.A. 2000, c. o-4 ON THE PART OF THE RELEASEES. I UNDERSTAND THAT NEGLIGENCE INCLUDES THE FAILURE ON PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME/MY CHILD FROM THE RISKS, DANGERS AND HAZARDS REFERRED TO ABOVE.

Signature of Parent/Guardian or Participant (if over 18):

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Personal Information Protection Act (PIPA) and Email Communication Acceptance

As a parent/guardian or participant attending this gymnastics club, I give consent for the purposes of collecting information. Your contact information will be kept confidential and made available only to the staff of Kyle Shewfelt Gymnastics.

Photo/Video Release

By signing below, I AGREE to give permission to Kyle Shewfelt Gymnastics to take pictures or video of me/my child during my/their participation in any program, and that these may be used for advertising, club noticeboard, club website, and any social media platform. I am of the understanding that my child’s full name WILL NOT appear in relationship to any photographs or videos without additional written consent.

I also AGREE to give permission to Kyle Shewfelt Gymnastics to take pictures or video of me/my child during my/their participation in any program, and that these may be used for training purposes.

*Note: should you chose, you can withdraw your Photo/Video consent in written notice at any time. Please email info@ksgymnastics.com to withdraw.

I Agree

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Adult Minor(s)Adult and Minor(s)
1 Minor 2 Minors 3 Minors 4 Minors 5 Minors More Minors 6 Minors 7 Minors 8 Minors 9 Minors 10 Minors

Signed this day of September 26, 2023 at Calgary.

QUESTIONS, COMMENTS, CONCERNS or ADDITIONAL INFORMATION REQUIRED

If you have any questions, comments, concerns or require additional information regarding these waiver forms, please contact Kyle Shewfelt Gymnastics directly by phone: 587-349-2004, email: info@ksgymnastics.com or in person at our facilily: 104 - 3442 118 Avenue SE, Calgary, Alberta.

DO NOT sign this waiver if you have additional questions.

By signing, I acknowledge that I have no further questions at this time and that it has been made clear to me that I can ask questions at any time.

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First Participant's Name

First Name*

Last Name*

Phone*

First Participant's Date of Birth*

First Participant's Signature*

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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*

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*

By checking this box, I provide my consent to receive information, news and updates from Kyle Shewfelt Gymnastics via email. I understand that I will have the option to unsubscribe at any time.

Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant

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*

Phone*

Parent or Guardian's Date of Birth*

Parent or Guardian's Signature*

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