TgRegForm

Registration & Release Form
Please choose one*

Private LessonsTumbling ClassesBaby JagsVarsity Pro League
ATHLETE INFORMATION*

First NameMiddle NameLast Name
Gender*

M/MaleF/Female
Date of Birth (MM/DD/YYYY)
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMAIL ADDRESS
example@example.com
PHONE NUMBER

PARENT INFORMATION ( if under 18)

First NameLast Name
RELATIONSHIP TO ATHLETE
EMAIL
example@example.com
Parent/Guardian Phone Number
PARENT INFORMATION

First NameLast Name
Parent/Guardian Phone Number

MEDICAL INFORMATION
Please list any physical / psychological limitations, health conditions, injuries, or weakness that may affect the athlete’s participation and/ or performance.
Allergies
Medications (list all)
Emergency Contact (First & Last Name)*
Relationship*
Phone Number*
Insurance Carrier
Policy #

TOP GUN CHEER AND DANCE TRAINING CENTER INC.

HEREIN AFTER REFERRED TO AS ¨TOP GUN¨
ACKNOWLEDGEMENT, AUTHORIZATION AND RELEASE FORM
In consideration for the participating athlete in the activities provided by Top Gun, including but not limited to all aspects of cheerleading, tumbling, trampoline, and dance training and/or competition, I am fully aware that any activity involving motion, height, or athletic activity creates the possibility of serious injury and/or death. I hereby release Top Gun, including its officers, shareholders, agents, and employees, from any liability to the above named athlete, of the person claiming through him/her, arising from injury to the person or property of the above named athlete occurring on the premise of Top Gun, including any event sponsored or sanctioned by Top Gun, and/or travel to and from such activities. This release includes but is not limited to any claims of negligence, dangerous condition, latent defect, premises liability, code violation, negligent security, failure to warn, vicarious liability, negligent hiring, negligent supervision, negligent maintenance, or improper/ dangerous equipment; it is intended to be as broad as permissible under Florida Law. I am fully aware of the nature of the activities provided and the possibility of injuries arising from such activities. I further agree to hold harmless, indemnify and defend Top Gun, including its officers, shareholders, agents, and employees from any loss, liability, damage, or cost incurred by them due to the above named athlete on the premises or during any event sponsored or sanctioned by Top Gun. This release is intended to be binding upon the athlete, his/her heirs, assignees, and successor in interest, and anyone claiming by or through him/her. In addition, I give Top Gun permission to film, photograph, or videotape the above athlete for any reproductions, movies, televised events, or promotional print associated or in any way connected with Top Gun. I have read and understood the registration form and agree to all terms as stated above. I also attest that all information given is factual. I certify that the athlete is in good health and may participate in any Top Gun activities. In case of an emergency requiring medical treatment, the undersigned hereby authorizes Top Gun to take the above named athlete to a qualified medical or hospital facility for care and treatment.
Parent/Guardian/ Athletes 18 & OlderName
Parent/Guardian/Athletes 18 & Older Signature*

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Registration & Release Form

MEDICAL INFORMATION

TOP GUN CHEER AND DANCE TRAINING CENTER INC.

ACKNOWLEDGEMENT, AUTHORIZATION AND RELEASE FORM