PLEASE LIST ANY PHYSICAL AND/OR SOCIAL CONDITION WHICH MAY AFFECT YOUR CHILD'S PERFORMANCE IN CLASS. (PLEASE LIST SIGNIFICANT PAST INJURIES, ALLERGIES, WEIGHT PROBLEMS, FEARS, ETC.)

PLEASE LIST THE NAME OF A CLOSE FRIEND OR RELATIVE WHO COULD BE REACHED IN AN EMERGENCY IF PARENTS CANNOT BE REACHED:

Emergency Name: Phone #:

LIABILITY RELEASE

BY CLICKING THE SUBMIT BUTTON BELOW, I, AS PARENT/LEGAL GUARDIAN OF THE CHILD LISTED ABOVE, APPROVE AND GIVE MY PERMISSION FOR HIM/HER TO BE A MEMBER OF MY FIRST GYM, MY FIRST GYM TUMBLE BUS AND/OR HILL COUNTRY ALL STAR CHEERLEADING, AND TO PARTICIPATE IN ANY EXHIBITION PROGRAM. I ALSO UNDERSTAND THAT HIS/HER PARTICIPATION IN GYMNASTICS / TUMBLING / CHEERLEADING ACTIVITIES INVOLVES MOTION, ROTATION AND WEIGHT IN A UNIQUE ENVIRONMENT AND AS SUH CARRIES WITH IT A REASONABLE ASSUMPTION OF RISK. CATASTROPHIC INJURY, FOR ANY AND ALL HOSPITALIZATION, MEDICAL OR EMERGENCY TREATMENT BY PROVIDING PROPER INSURANCE COVERAGE, OR WILL ASSUME THE COST DUE TO INJURY. I WILL NOT HOLD MY FIRST GYM, MY FIRST GYM TUMBLE BUS, HILL COUNTRY SPIRIT ACADEMY AND/OR ANY OF ITS OFFICERS OR EMPLOYEES RESPONSIBLE IN ANY WAY FOR SUCH COSTS WHICH MAY OCCUR. I HAVE REVIEWED THE RULES AND POLICIES OF MY FIRST GYM AND UNDERSTAND THAT HE/SHE IS RESPONSIBLE FOR HIS/HER ACTIONS WHILE PARTICIPATING IN ALL CLUB ACTIVITIES. IN CASE OF AN EMERGENCY, MY FIRST GYM'S STAFF HAS MY PERMISSION TO REQUEST MEDICAL ATTENTION FOR MY CHILD. I WILL NOTIFY MY FIRST GYM IN WRITING ONE MONTH PRIOR TO WITHDRAWING FROM A CLASS OR LEAVING THE CENTER. OTHERWISE I WILL BE HELD RESPONSIBLE FOR ANY AND ALL CHARGES INCURRED UNTIL SUCH NOTICE IS RECEIVED BY MY FIRST GYM.