Private Lesson Waiver & Request Form

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.

I understand upon signing this document, after my trial period I have the option to continue at anytime during my 3-Week trial. If I choose to stop I will no longer be charged. If however, I choose to continue I agree to paying monthly tuition and at anytime I decide to drop I understand I must submit a 30 day drop form

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.