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WAIVER OF LIABILITY

PLEASE READ CAREFULLY!

 

The Participant desire that as a Participant in fLipSpot, the Participant engage in the activities related to being a Participant (the “Activities”). The Participant and Guardian understand the Activities may include tumbling, cheer, gymnastics, other fLipSpot events, parties or field trips. The Participant hereby freely, voluntarily, and without duressexecutes this Release under the following terms:

 

Release and Waiver. Participant does hereby release and forever discharge and hold harmless fLipSpot and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which may arise or may hereafter arise from Participant’s Activities with fLipSpot. Participant understand that this Release discharges fLipSpot from any liability or claim that the Participant may have against fLipSpot with respect to bodily injury, personal injury, illness, death, or property damage that may result from Participant’s Activities with fLipSpot, whether caused by the negligence of fLipSpot or its officers, directors, employees, or agents or otherwise. Participant also understand that fLipSpot does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness.

 

Medical Treatment. Participant does hereby release and forever discharge fLipSpot from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Participant’s Activities with fLipSpot or with the decision by any representative or agent of fLipSpot to exercise the power to consent to medical or dental treatment as such power may be granted and authorized.

 

Assumption of the Risk. Participant hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases fLipSpot from all liability for injury, illness, death, or property damage resulting from the Activities.

 

Insurance. The Participant understands that, except as otherwise agreed to by fLipSpot in writing; fLipSpot does not carry or maintain health, medical, or disability insurance coverage for any Participant. Each Participant is expected and encouraged to obtain his or her own medical or health insurance coverage.

 

Photographic Release. Participant does hereby grant and convey unto fLipSpot all right, title, and interest in any and all photographic images and video or audio recordings made by fLipSpot during the Participant’s Activities with fLipSpot, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

 

Other. Participant expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Michigan, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Michigan. Participant agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.

 

I have received or will obtain a copy of fLipSpot Gymnastics

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Please list any medical conditions or allergies:
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Please list any medical conditions or allergies:
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Please list any medical conditions or allergies:
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Please list any medical conditions or allergies:
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Please list any medical conditions or allergies:
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Please list any medical conditions or allergies:
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Please list any medical conditions or allergies:
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Please list any medical conditions or allergies:
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Please list any medical conditions or allergies:
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Please list any medical conditions or allergies:
11 Participant's Name

First Name*

Middle Name

Last Name*
11 Participant's Date of Birth*
11 Participant's Information

Please list any medical conditions or allergies:
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
Email me a copy of this document.
Payments

Effective 8/1/2013, I agree to fLipSpot Gymnastic & Cheer's automated payment system for tuition.  Tuition payments will be processed with the major credit or debit card I have on file with fLipspot to be used on my scheduled due date.   If I choose to pay by cash or check, my payment will be made prior to the Monday of tuition due week to avoid automated processing.  Recreational class tuition that is 7 days past due or more will be assesses a $25.00 late fee.  Team tuition that is 10 days past due or more will be charged the $25.00 late fee.


Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Please list any medical conditions or allergies:
Parent or Guardian's Signature
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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