Gymnastic World of Fort Myers
BIRTHDAY PARTIES & OPEN GYM
RELEASE/CONSENT FORM
Gymnastic World of Fort Myers, it’s coaches and other staff members, do not accept and will not be held responsible for injuries sustained by any member, student or visitor during the course of gymnastics, tumbling, dance or cheerleading instruction, open gym times, birthday parties, lockins, camps or in the course of any exhibition, competition or clinic in which she/he may participate or while traveling to or from any event. With the above in mind and being fully aware of the risks and possibility of injury involved, I _______________________________, as parent/legal guardian of the below named child(ren), consent to have my child(ren) participate in the programs offered by Gymnastic World of Fort Myers. I further agree that I, my executors or other representatives, hereby waive, hold harmless and fully release all rights and claims for damages that I or my child(ren) may have against Gymnastic World of Fort Myers, and/or its representatives whether paid or volunteer.
Child’s First and Last Name_________________ DOB__________
Street Address City State Zip _____________________________________
Parent/Legal Guardian Full Name_________________________________
Parent/Legal Guardian Signature__________________________________
Cell Phone Number____________Work/Day Phone Number____________