



|
Register
Today |

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All
For
$110 |
|
Deadline
For Registration is June 22 |
Name:_________________________________Birthdate_________Age:__________GymnasticsExperience:_____________________
Address________________________________________________ City,
State, Zip_____________________________________ Home
Phone(
) ______________Cell
Phone(
)_________ Emergency
Phone:____________
Parent or Gaurdian: __________ In
consideration of permission granted to my child(ren) by Flyaways Gold Gymnastics
Inc., and MD2B Inc. to participate in gymnastics & related activities under
their supervision, I hereby release and discharge Flyaways Gold Gymnastics,
Inc., and MD2B Inc. of Forest Lake, MN,
it’s and their agents, employees, officers, shareholders, directors,
successors and assigns from any and all claims, demands, judgments and
executions which the undersigned and/or the undersigned’s child and/or the
undersigned’s family had may have, or claim to have, against Flyaways Gold
Gymnastics, Inc., and MD2B their agents, employees, officers, shareholders,
directors, successors and assigns, for all personal injuries, property damage
and other damages, known or unknown, real or personal, caused by or arising out
of the above-described gymnastics
or related activities. I
further agree to indemnify and hold Flyaways Gold Gymnastic, Inc., and MD2B
Inc., and their agents, employees, officers, shareholders, directors, successors
and assigns, harmless from and against any and all such claims, injuries or
damages. I
give permission to Flyaways Gold Gymnastics Inc., and MD2B Inc., to take
whatever emergency (e.g. first aid, disaster evacuation) measures that are
judged necessary for the care and protection of my child(ren) while under the
supervision of the center. In
case of medical emergency, I understand that my child will be transported to an
appropriate medical facility by the local emergency unit for treatment if the
local emergency resource (police, rescue squad) deems it necessary. The child will be transported at the
expense of your primary medical coverage. It
is understood that in some medical situations, the staff will need to contact
the local emergency resource before notifying the parent, child’s physician,
and/or other adult acting on the parent’s behalf. I,
the undersigned, have read this release and understand its terms. I execute it voluntarily and with full
knowledge of its significance. WARNING!
CATASTROPHIC INJURY, PARALYSIS OR DEATH CAN RESULT FROM THE IMPROPER CONDUCT OF
THIS ACTIVITY. ____________________________________________________________________
Month _____ Date______
Year______
_____________________________ (Parent or
Guardian |