2018 GYMNASTICS CAMP REGISTRATION FORM
You can Fill out this form online: Summer Camp Registration 2018!
Please circle which week you want your child take gymnastics camp and remember you can get a $10 discount on the second week if your child attends both camps.
O —- JUNE 18-22nd from 8:00 am – 3:00 pm ( Ingrid’s Location )
O —- JUNE 11-15 from 8:00 am – 3:00 pm ( Trussville Location
O —- TEAM ONLY CAMP — July 9th-13th $185
Cost: $165 per week
Activities: Artistic and Rhythmic Gymnastics, Water Activities, Art, Theatre, Spanish and much more.
Ingrid’s Gymnastics and Cheer, LLC
Name: ______________________________Age ____ Date of Birth: __________ Gender ______
Address: __________________________________City ____________________ Zip _______
Email address: ________________________________ Home phone: ______________________
Mother’s name: ____________________________Cell #: _____________ Work #: ___________
Father’s name: _____________________________Cell #: _____________Work #____________
Emergency contact (other than parents) ______________________________
Persons to whom child may be released _____________________________
Phone #:_________________________ Phone #: ___________________________
Health Insurance Company __________________________________________
Contract# _________________________ Group # _________________________
Effective Date ___________ Policy Holder _____________________________
Allergies / health problems: _________________________________________
Being the parent and/or legal guardian of _____________________________, I fully understand that the nature of gymnastics involves jumping, twisting, flipping, landing, etc. Precautions are in place at the gymnasium to protect my child from injury but accidents, however rare, are possible. I am willing to assume these risks on behalf of my child. I hereby certify that my child is fully capable of participating in gymnastics and that my child is healthy with no physical or mental disabilities that would restrict full participation in the activities of the gymnastics and cheer programs. In addition to giving my full consent for my child’s participation, I do hereby waive, release, and hold absolutely harmless Ingrid’s Gymnastics and Cheer, LLC and its coaches for any injury that may be suffered by my child, whether the result of negligence or any other cause. I understand that Ingrid’s Gymnastics and Cheer, LLC will not be liable in any way for medical, doctor, hospital, or dental expenses. It is my specific understanding by signing this document that all parents and guardians of my child will be giving up the right to all claims, suits, causes of actions, demands, monies, attorney’s fees and judgments.
I ________________________________ give my permission to Mrs. Ingrid Pfau to authorize any emergency medical treatment that my child/ward may require during the 2018 gymnastics session.
Parents or guardian signature date