PLEASE PRINT, COMPLETE AND MAIL IN YOUR REGISTRAITON. THANK YOU
Flip-Flop Gymnastics & Cheer, Inc. APPRECIATION OF RISK: Participation in gymnastics and/or cheer/tumbling activities involves motion, rotation and height in a unique environment and as such carries with it a reasonable assumption of risk. WARNING: Catastrophic injury, paralysis and even death can result from improper conduct of the gymnastics/cheer/tumbling activity. Appreciate this warning as well as the fact that even under the best conditions, participation in gymnastics, cheerleading and tumbling activities involves inherent risks on the part of the participant. This is to certify that the undersigned have carefully read and understand the inherent risks of gymnastics/cheerleading and tumbling participation are adequately appreciated and that said participation is done on a strictly voluntary basis.
In consideration of the opportunity afforded, the below stated minor child is to participate in a formal or informal gymnastics/cheerleading/tumbling class of instruction and in recognition of the possibility of an injury from such participation, I/We the parent(s) or guardian(s) of said minor child do hereby acknowledge knowingly, freely and voluntarily waive any right or cause of action of any kind whatsoever, arising as a result of such activity from which any disability could or may accrue to Flip-Flop Gymnastics Academy, Inc., Pine Bluff School of Gymnastics, Inc. Patricia C. Desonie, Lee E. Desonie III, their agents, representatives and assigns.
I/We agree to pay FULL tuition. If I/we choose to cease participation in class, I will give a 30 day written notice. FULL tuition is due by the 8th of each month or a $10 late fee will be charged. & additionally $5 more each week tuition continues to be late NO EXCEPTIONS!!!! Sibling discounts DO NOT apply when tuition is paid late!_____Initial, please!
Choose how you will pay: Circle one MONTHLY QUARTERLY
DATE OF SIGN UP PARENT OR GUARDIAN
MINOR’S DATE OF BIRTH PARENT OR GUARDIAN
MINOR’S NAME CLASS DAY & TIME GYM OR CHEER
MAILING ADDRESS CITY ZIP CODE HOME PHONE NUMBER
MOM CELL DAD CELL EMERGENCY CONTACT/PHONE NUMBER
EMAIL ADDRESS ALTERNATE CONTACT NAME/PHONE NUMBER
Please list any instructions you would wish followed in the event of an emergency. Also list any personal information you might feel helpful for us to know concerning your child.
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