Summer acro intensive
With Coach Levi
Wednesdays Sessions (6/21, 6/28, 7/12, 7/19, 7/26, 8/2)
9:45am-11:15am
Athlete’s name
*
First Name
Last Name
Athlete’s age
*
What does your athlete use acro for? (Select all that apply)
*
Studio dance
School Pom
Recreational
Other
Give me a little background on your athlete's acro/tumbling experience, and what skill(s) they look forward working on during this time.
*
Parent’s name
*
First Name
Last Name
Parent’s phone number
*
Please enter a valid phone number.
Parent’s email
*
example@example.com
Assumption of risk - The minor's parent and/or legal guardian, understand the nature of tumbling and the minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I fully understand that tumbling involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or in-actions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the minor named on this digital registration form under "Tumbler's name"; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of participation in tumbling.
*
Release of liability - I do hereby release, protect, indemnify and hold harmless, Coach Levi Nickson, Tumble Smart Athletics LTD. CO. , it's employees, board members and volunteers, from and against all claims, liabilities, suits, actions, or proceedings which may arise out of, or in any way be connected with, any illness, injury or even death occurring during on-site or off-site tumbling. This indemnity shall include, but shall not be limited to, indemnification with respect to any costs of defense and attorney fees.
*
Video release - I hereby give Coach Levi Nickson and Tumble Smart Athletics LTD. CO. permission to use photographs and video recordings of my child for all purposes, including advertising, training and social media posts.
*
*
prev
next
( X )
Pay for spot in Wednesday 6 week session
$
285.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Submit
Submit
Should be Empty: