Gym-Nation
Gymnastics, Dance,
Cheer & Martial Arts Safety Waiver
www.gym-nation.net
As
a responsible sports organization we, Gym-Nation, believe it is our duty to
inform you, the parents of the students at our club, of the potential risks
involved in the sport of gymnastics, dance and karate. As with any sport, there is the real
possibility of injury.
We
take every precaution possible to prevent injuries of any kind. We believe we have a very safe program and
are always looking for new ways to teach gymnastics, dance and karate more
safely. We emphasize safety with all of
our instructors and coaches. Safety is
their number one consideration while teaching.
However, accidents can still happen.
Gymnastics, tumbling, dance and martial arts can be dangerous and can lead to an
injury. Students may suffer injuries,
possibly minor, serious or catastrophic in nature. Because of the dangers of the sport, parents
should make their children aware of the possibility of injury and encourage
their children to follow all the safety rules and the coaches’ instructions.
Warning: Catastrophic injury, paralysis or even death
can result from the improper conduct of the activity.
I
understand that Gym-Nation staff members are not physicians or medical
practitioners of any kind. With that in
mind, I hereby release the Gym-Nation staff to render temporary first aid to my
child or children in the event of any injury or illness, and if deemed
necessary to call our doctor and to seek medical help, including transportation
by a Gym-Nation staff member and or its representatives, whether paid or
volunteer, to any health care facility or hospital, or the calling of an
ambulance for said child should the Gym-Nation staff deem it to be
necessary. The child will be transported
at my expense. I give my permission to
Gym-Nation and/or appropriate medical facility to make whatever emergency
measures as deemed necessary for the care and protection of my child while
under the supervision of Gym-Nation.
I
understand that Gym-Nation, its coaches and other staff members will not accept
the responsibility for injuries sustained by any students during the course of
gymnastics, tumbling, dance or martial arts instruction, or open workouts, or
in the course of any exhibition, competition, or clinic in which he or she may
participate or while traveling to or from the event. The terms hereof serve as a release and
assumption of risk for my heirs, estate, and for all member of my family.
In
consideration for allowing me to participate, I hereby assume all the risks
associated with the sport of gymnastics, dance and karate and agree to hold the
gym, its owners, employees or agents harmless from any and all liability,
causes of action, debts, claims, or demands of any nature whatsoever which may
arise in connection with my participation in any activities related to the
sport. The terms serve as a release.
Students Name:____________________________________ Sex:
M / F Age:____ DOB:_____________
Parent/Guardian:__________________________________________________ Home Phone:________________________
Address:_______________________________________________________
Mother’s Cell Phone:_______________________
City:_______________________________ State:______ Zip:_________
Email
_____________________________________________________________________________
I did read, and accepted Gym-Nation’s Team Rules
& Policies (Available in the office and online)
Parent/Guardian Signature:_________________________________________________________Date:___________________
Waivers are mandatory for all non-members that take part in any activity
at Gym-Nation. They are good for one
calendar year after they have been signed