GYMNASTIC WORLD Camp Registration Form
Childs’s Name:___________________________________ Birth Date: _____________
Address:________________________________________________ City:_____________ State:____ Zip______
Mother’s Name:_________________________ Cell___________________ Work_____________________________
Father’s Name:________________________ _ Cell_______________________ Work_________________________
Alternative Emergency Contact:______________________________
Does your child have any allergies (medicine/food/etc) YES/NO
If you answered yes to any of the above, please explain:______________________________________________
_________initial There are no refunds, no exceptions.
_________initial Parent or Guardian must have a pick up card(or a screen shot of pick up card can be sent to who will be picking up your camper) Please know: This is for your child’s safety.
_________initial You must sign your gymnast out of camp to go to classes. (Gymnast will not be excused from camp to go to classes) A parent must sign them out to go to class.
_________initial Campers must be a minimum of 5 years of age, no exceptions.
_________initial Payment is required at the time of drop off, no exceptions. (Card on file will be used if no payment has been made)
_________initial Camp ends at 3pm (half day) and 6pm (full day). If you are 10 minutes late a $15 charge will be charged to your account. (and $10 every 15 minutes after)
If at any time information changes, please inform Gymnastic World office staff of updates
LIABILITY RELEASE & CONSENT
Gymnastic World of Fort Myers, its 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 other activities during 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 a parent/guardian of the above 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.
Parent Signature:__________________________________________________________________________ Date:________________