1 Step 1 SNMC Child's First name Child's Last name DOBdate_range Parents Name Cell number during SNMC Address Town Zip Emailbest email for us to reach youemail Health issuesPlease ouline any health issues you feel will impact your child at SNMC0 / Sign me up for the following days.MAY 14: Full.... Please put my name on the waitlist Payment informationPlease note that registration is not finalized until payment has been received in fullCharge my card on file.I will call with a credit card SNMC Administrative Policies There are no refunds for any missed SNMC. Dates can be changed, space permitting if we are notified at least 4 days before the SNMC. All requests for date changes must be made via email to [email protected] Make ups for missed camp days are not available. Full refunds will be available if Covid related restrictions prevent us from operating. ConfirmationI have read and acknowledge the above administrative policies. Waiver/Release I, the duly authorized parent or guardian of the above-named Minor “Participant”, understand that the individual and/or group gymnastics and other physical exercise sessions, programs or activities conducted at Action Kids at Brentwood Commons, Inc. (hereafter “Action Kids”) may involve gymnastics, tumbling, fitness, trampoline, cheerleading, dance, ball sports, swimming and martial arts, as well as the use of exercise equipment, amenities and facilities owned and/or operated by Action Kids, its representatives or its contractors (collectively, the “Activities”). I, as the parent/guardian of the below-named Minor Participant, as a condition of authorizing their participation in such Activities do hereby agree to RELEASE and DEFEND, HOLD HARMLESS, and INDEMNIFY Action Kids, its shareholders, directors, officers, agents, faculty, volunteers, employees, representatives and contractors (hereinafter “the Releasees”) from all liability, claims, expenses, fees, fines, penalties, losses, suits, proceedings, actions and costs including attorneys’ fees and court costs, including personal injury and death, resulting from or arising out of their participation in the Activities whether caused by the alleged NEGLIGENCE of the Releasees or otherwise. I understand that the Activities in which my child or ward will be engaged may be dangerous, and I, as their parent or guardian, voluntarily choose to assume those dangers. I also recognize that by participating in the Activities my child or ward may experience injuries including, but not limited to, death or disability, and I willfully ASSUME THOSE RISKS. I agree that THIS LIABILITY RELEASE AGREEMENT IS BINDING ON THE PARTICIPANT AND THEIR PARENTS OR LEGAL GUARDIANS, PERSONAL REPRESENTATIVES, HEIRS, AND ASSIGNS. In the event of accident or emergency, I hereby authorize Action Kids to transport the Participant, or cause the Participant to be transported, to a medical facility for medical treatment and I agree to release, indemnify, defend and hold Action Kids and its representatives harmless with regard to same. I hereby agree to be fully and solely responsible for all medical expenses which may be incurred as a result of the Participant’s participation in the Activities. I understand that my child or ward’s participation in the Activities at Action Kids may be photographed, video recorded, audio recorded, or otherwise recorded. I acknowledge that Action Kids retains the right to use such photographs, video or audio recordings or any other recording of events for publicity, advertisement or any other legitimate purpose and I hereby consent to such use. ConfirmationI, as the parent or guardian of the above-named Minor Participant, certify that I have carefully read the foregoing Liability Release Agreement and by my signature below, including any signature affixed in electronic format, consent to be bound by its terms. If I am not the parent or guardian of the below-named Minor Participant, by my signature below, I nevertheless agree to all of the terms and obligations in this Liability Release Agreement, as though I was the parent or guardian of the Minor Participant. Electronic SignatureParent/Legal Guardian Full Name Datedate_range Submit Form keyboard_arrow_leftPrevious Nextkeyboard_arrow_right FormCraft - WordPress form builder
