Parent's Name___________________________________________________________________________
Address___________________________________________________________________________________
City_____________________________________________ State_____________ Zip___________________
Home Phone__________________________________Cell_______________________________________
Email______________________________________________________________________________________
Emergency Contact_______________________________________Emer. Cell___________________
Student Information
Name_______________________________________________________M / F DOB__________________
Class Day: M T W Th S Class Time:________________________
Class Type: PT/PS Beg/Inter Adv Tumble S/C Cheer Pre-Team Team
Medical Conditions______________________________________________________________________
Name_______________________________________________________M / F DOB__________________
Class Day: M T W Th S Class Time:________________________
Class Type: PT/PS Beg/Inter Adv Tumble S/C Cheer Pre-Team Team
Medical Conditions______________________________________________________________________
Name_______________________________________________________M / F DOB__________________
Class Day: M T W Th S Class Time:________________________
Class Type: PT/PS Beg/Inter Adv Tumble S/C Cheer Pre-Team Team
Medical Conditions______________________________________________________________________
Office Only
Date_______________________ $30 Registraction Fee Check #__________Cash__________
Registration: A $30 non-refundable membership fee is required at the time of registration. Membership fee is not deducted from student's tuition. Student will not be allowed into any class without a '18 - '19 registration form completed by a parent or legal guardian and has paid the membership fee. INITIAL__________
Tuition: Session fees are determined by a slot allocation, not by attendance. Therefore, all fees are due regardless of attendance. Tuition payments are non-refundable, except in the situation of a severe illness or injury. Requests for refunds in the above listed cases must be accompanied by a doctor's note. Once you have registered for a class, it is assumed that you will hold that slot until the end of the year show in June. It is not necessary to "re-register" for each session. However, a written notification is required in order to drop from the program, (sign a drop out card at front desk) or you may be responsible for paying your child's tuition for the slot in class. There will be a $25 service charge for any returned checks and a $10 late fee for any payments not paid within the session. INITIAL__________
Makeups: One makeup class is allowed per session. All missed classes not made up within the session will be forfeited and will not be pro-rated to future sessions. Exceptions to the above are: scheduled holiday closings and snow days. Makeup classes need to be scheduled with the front desk. INITIAL__________
Cancellations: Fliptastics Gymnastics reserves the right to cancel a class if less than 4 students are enrolled, as well as change the class instructor if necessary. Fliptastics Gymnastics reserves the right to cancel class due to inclement weather for everyone's safety. INITIAL___________
WAIVER and RELEASE
Gymnastics is an exciting and rewarding sport, but by the very nature of the activity, gymnastics carries the risk of physical injury. No matter how careful the gymnast and the coach are, no matter how many spotters are used, no matter what height is used, of what landing surface exists, the risk cannot be eliminated. The risk of injury includes minor injuries such as bruises and more serious injuries such as broken bones, dislocations, muscle pulls and sprains. The risk includes and always includes catastrophic injuries such as permanent paralysis and/or death.
I agree to hold harmless Fliptastics Gymnastics, its owner, employees, volunteers and agents from any claims or liability related to an accident that may occur
I give Fliptastics Gymnastics permission to transport the student to the nearest hospital in the event of an emergency. I further consent to medical treatment, if necessary, if parent, legal guardian or emergency contact person cannot be reached.
INITIAL__________
I have read and understand the above policies, waiver and release
Parent or legal guardian signature____________________________________________________
Date_________________________________________________________