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All Star Gymnastics Waiver/Release Form

Read the following carefully and sign below. NOTE: Parent must sign if student is under 18.

Athlete Membership Agreement and Information

In consideration of my membership in All Star Gymnastics, and my participation in All Star Gymnastics classes, events, and activities, I agree to be bound by each of the following:

  1. Eligibility: I agree to comply with the rules of All Star Gymnastics.
  2. Readiness to Participate: I will only participate in those All Star Gymnastics classes, events, competition, and activities for which I believe I am physically and psychologically prepared. Prior to participation, I will have practiced my exercises and will perform only those exercises which I have accomplished to the degree of confidence necessary to assure I can perform them by myself, and without injury.
  3. Medical Attention: I hereby give consent to All Star Gymnastics and/or the host organization to provide, through a medical staff of its choice, customary medical/athletic training, transportation, and emergency medical services as warranted in the course of my participation.
  4. Waiver and Relase: I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, and even death, as well as other damages, and losses associated with participation in gymnastics activities and events. I further agree that All Star Gymnastics, and the sponsor of any All Star Gymnastics event, along with the employees, agents, officers, and directors of these organizations shall not be liable for any losses or damages occurring as a result of participation in the event.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth
First Participant's Signature
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
11 Participant's Date of Birth
Parent or Guardian's Email Address

Email*

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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Insurance Provider

Primary Medical Insurance: I am covered by a primary health/medical/accident insurance through:*
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*

Last Name*
Parent or Guardian's Date of Birth
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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