WAIVER AND RELEASE FORM FOR GYMNASTICS, TUMBLING, CHEERLEADING, SILKS & HOOPS, & CONDITIONING CLASSES
Mendocino Starz Gymnastics 275 Kunzler Ranch Rd, Suite K, ukiah, CA95482 Phone# 707-463-3303 Website: www.starzgumca.com Email: :www.stanzymca@gmail.com
Mendocino Starz programs would like for you or your student to obtain a physical examination before participation. Affirmation of Good Health I, the parent or guardian of the minor named below, agree to allow my child to participate in the STARZ program for which she/he/they is enrolled. I acknowledge, due to the high level of exercise and physical activity. my child's health must be in good condition.I acknowledge she/helthey does not have any physical health problems that I am aware of that may interfere with the STARZ programs. I agree that if or my child has any physical condition that may impair the ability to engage in these programs, it is my responsibility to obtain a written statement describing any limitations. I agree that the Mendocino Starz Gymnastics employees are to make no evaluation whether my child is physically fit for any of these programs. Hold Harmless Agreement am aware that my child will be performing in various sports, coordination events and fitness training that may cause injury. Tagree that I hearby waive any claims or rights that my child orl might otherwise have to seek litigation against Mendocino Starz Gymnastics, their employees or offices for injuries that might occur as a result of these activities. By signing am consenting that my child is voluntarily participat- ing in these programs and am assuming any injuries that may occur. Agreement with Rules of Conduct also agree that I have talked with my child and understand that the STARZ program is serious about main- taining a strict learning environment and will not tolerate any misbehavior or misconduct Photo Release Igrant Mendocino Starz Gymnastics, the right to take photographs of me and my family in connection with any event related to Mendocino Starz Gymnastics. Tagree that Mendocino Starz Gymnastics, may use such photographs of me with or without my name and for any lawfu purpose, including for example such purposes as publicity. illustration, advertising, social media and Web content It is most important that you take this time to read and understand all that is involved with our waiver and release form. Please fill out and sign the bottom portion: