Registration And Release Form (Page 2 of 2) in pdf

RELEASE AND WAIVER LIABILITY, ASSUMPTION OF RISK, AND INDEMITY AGREEMENT

In consideration of being permitted to participate in any way in the gymnastics program indicated in the registration form and/or

being permitted to enter, for any purpose, any restricted area for unrelated gymnastics activities the parent (s) and /or legal guardians of the

minor participant named, agree:

I represent that I understand the nature of this Activity and that I or my child is qualified, in good health, and in proper physical

condition to participate in the activity. We fully understand that this activity involves risks of serious bodily injury, including permanent

disability, paralysis and death, which may be caused by my own actions, or inactions or those of others participating in the event, the

conditions in which the event takes place, or the negligence of the “releases” named below; and that there may be other risks either not

known to me and my child or not readily foreseeable at this time; and we fully accept and assume all such risks and all responsibility for

losses, cost, and damages I or my child incurs as a result of my or my child’s participation in the activity.

I herby release, discharge and covenant not to sue Valley Sports Clubs, Inc. dba Champion Gymnastics Academy, its respective

administrators, directors, agents, officers, volunteers , and employees, other participants, and sponsors, advertisers, owners and lessors of

premises on which the activity takes place, (each considered one of the “releasees” herein) from all liability, claims, demands, losses, or

damages caused or alleged to be caused in whole or in part by negligence of the “releasees” or otherwise, including negligent rescue

operations. I agree that if, despite this release, waiver of liability, and assumption of risk, that if I, or anyone on my behalf, makes a claim

against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability damage, or cost, which

any Releasee may incur as the result of such claim.

I have read the Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement, and understand that I have given

up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a

complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held

to be invalid, the balance, notwithstanding shall continue in full force and effect.

Signature: ________________________________ Date: _______________

(Parent)

Signature: ________________________________ Date: _______________

(Participant)

Parent Consent

And I, the minor’s parent and/or legal guardian, understand the nature of the above referenced activities and the minor’s experience

and capabilities and believe the minor to be qualified to participate in such activity. I herby release, discharge, covenant not to sue and

AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the releasees from liability, claims, demands, losses, or damages

on the minor’s account caused or alleged to have been caused in whole or in part by negligence of the releasee or otherwise, including

negligent rescue operations, and further agree that if, despite this release, the minor, or anyone on the minor’s behalf, makes claim against

any of the above releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the releasees from any litigation expenses,

attorney fees, loss liability, damage, or cost any releasee may incur as the result of any such claim.

______________________________________

Printed name of parent/or legal guardian

______________________________________

Date: ___________________________

Signature of parent/or legal guardian

Authorization To Consent To The Treatment Of A Minor

I, we the undersigned, parents of _____________________ a minor, do hereby authorize any adult instructor of Champion Gymnastics

Academy, as agent(s) for the undersigned, to consent to any medical treatment and/or call 911 and/or for hospital care which is deemed

advisable by, and is rendered under the general or special supervision of any physician or surgeon licensed under the provisions of the

Medical Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or at the hospital.

It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, but is given to

provide authority and power on the part of our aforesaid agent to give specific consent to any an all such diagnosis, treatment or hospital care

which the aforementioned physician in the exercise of his best judgment may deem advisable. This authorization is given pursuant to the

provisions of Section 25.8 of the Civil Code of California.

This authorization shall remain effective indefinitely, unless sooner revoked in writing and delivered to said agent(s).

PARENT/LEGAL GUARDIAN:_________________________________

DATE:______________________

Registration And Release Form Page 2

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