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) ______________________________

Phone #:_________________________

Persons to whom child may be released _____________________________

Phone #:_________________________ Phone #: ___________________________

Health Insurance Company __________________________________________

Contract# _________________________ Group # _________________________

Effective Date ___________ Policy Holder _____________________________

Allergies / health problems: _________________________________________

Medications: _________________________________________________________

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