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  • Athlete Information

  • Parent/Guardian Information

  • Pick Up Authorization

  • Informed Consent and Acknowledgment

    I hereby give my approval for my child’s participation in any and all activities prepared by Tumble Shine Gymnastics, LLC during the selected camp. In exchange for the acceptance of said child’s candidacy by  Tumble Shine Gymnastics, LLC ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Tumble Shine Gymnastics, LLC . and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

    In case of injury to said child, I hereby waive all claims against Tumble Shine Gymnastics, LLC . including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include but are not limited to, the risk of fractures, paralysis, or death.

    I fully understand that Tumble Shine Gymnastics, LLC staff members are not physicians or medical practitioners of any kind. With the above in mind, I hereby release the Tumble Shine Gymnastics, LLC staff to render temporary first aid to my child or children in the event of any injury or illness, and if deemed necessary by the Tumble Shine Gymnastics, LLC staff to call our doctor and to seek medical help, including transportation by a Tumble Shine Gymnastics, LLC staff member and or its representatives, whether paid or volunteer, to any health care facility or hospital, or the calling of an ambulance for the said child should the Tumble Shine Gymnastics, LLC staff deem this to be necessary. We the staff of Tumble Shine Gymnastics, LLC. recognize our obligation to make our students and their parents fully aware of the inherent risks and hazards associated with the sport of gymnastics, dance, and cheerleading, and that these students may suffer injuries, possibly minor, serious or catastrophic in nature due to the inherent hazards and risks with the above sports. Given the distinct possibility of injuries associated with the performance of these activities the Tumble Shine Gymnastics, LLC insists that all students and their parents agree to abide by all of the safety rules and policies of the Tumble Shine Gymnastics, LLC in regard to this matter. Tumble Shine Gymnastics, LLC it’s coaches and other staff members, whether paid or volunteer, will not accept responsibility for injuries sustained by any student during the course of gymnastics, tumbling, dance, cheerleading instruction, open workouts, or birthday parties, 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.

    I further acknowledge, understand, appreciate, and agree that my participation may result in possible exposure to and illness from infectious diseases, including, but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of others, and assume full responsibility my family and my child’s participation and exposure.

    I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage that I consider adequate for both my child’s protection and my own protection.

    I also understand that it is the parents’ responsibility to warn the child about the dangers of gymnastics and injury. The parent should warn the child according to what the parent feels is appropriate. The Tumble Shine Gymnastics, LLC will only warn the child through “safety messages” and our teaching style and progressions.

    By signing below, I state that I fully understand the information contained in the waiver as well as the rules and policies of Tumble Shine Gymnastics, LLC.

  • Medical Release and Authorization

    As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

    Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

    Permission is also granted to Tumble Shine. and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

    Release authorized on the dates and/or duration of the registered season.

    This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

  • Transportation Section

    "This Release, Waiver and Indemnity Agreement (“Release”) is entered into by and between Tumble Shine Gymnastics, LLC and {athletesName} Participant’s parent(s) and/or guardian(s), namely {name} .

    Whereas Tumble Shine Gymnastics, LLC offers after school services and programs related to among other things, gymnastics, tumbling, and dancing (“After School Programs”) Whereas, Tumble Shine Gymnastics, LLC offers vehicular transportation from participants school or child care center to the Tumble Shine Gymnastics, LLC facility at 60 Old Wallaceton Road, Berea Kentucky. (“Transportation Program”) The Transportation Program also includes traveling to and transporting other participants enrolled in the After School Programs from their schools or child care centers to the Tumble Shine Gymnastics, LLC facility at 60 Old Wallaceton Road Berea Kentucky. Whereas, Tumble Shine Gymnastics, LLC requires participants to execute a release and waiver of liability and indemnity agreement to participate in the Transportation Program. Whereas, Participant and Custodians agree to execute this Release so that Participant may participate in the Transportation Program. Now, therefore, in consideration of Participant participating in the Transportation Program, Participant and Custodians, for and on behalf of themselves and Participant and for and on behalf of Participant’s estate, executors, administrators, personal representatives, heirs and next of kin, acknowledge, agree and represent that they:HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUEMarylen Kagan Watson, Tumble Shine Gymnastics, LLC or their heirs, successors or assigns or their members, managers, officers, directors, agents employees, contractors, subcontractors, agents, partners, affiliates and insurers, and all other related persons, firms, companies or corporations, or drivers, owners or lessees of any vehicles used for the Transportation Program, and each of them, all for the purposes herein referred to as “Releasees” relating to any and all claims, demands, obligations or liabilities for injuries and/or damages in any way arising out of or related to the Transportation Program, even if resulting in death, whether caused by the negligence of the Releasees or which arises out of, or in any way whatsoever, is related to or resulting from the Transportation Program.2.) HEREBY AGREE TO INDEMNITY, SAVE, HOLD HARMLESS AND DEFEND the Releasees, and each of them, from any loss liability, damage, cost, expense (including without limitation, actual attorney fees) claim, demand, judgment or other action whether pending or threatened, which may arise out of, or in any way whatsoever, be related to or resulting from the Transportation Program.3.) HEREBY ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE due to the negligence of the Releasees or that which may arise out of, or in any way whatsoever, be related to or resulting from the Transportation Program. The undersigned expressly acknowledge and agree that the Transportation Program provided by Releases could be dangerous and involve the risk of serious injury and/or death and/or property damage. The undersigned further expressly agrees that the foregoing Release, Waiver, and Indemnity Agreement is intended to be as broad and inclusive as is permitted by the law of the Commonwealth of Kentucky and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. THE UNDERSIGNED HAVE READ AND VOLUNTARILY SIGN THIS RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducements apart from the foregoing written agreement have been made

  • Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

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