Open Gym Registration

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Participant 1 Full Name:* This field is required.
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Participant 1 Date of Birth* This field is required.
mm/dd/yyyy
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Participant 2 Full Name:
4
Participant 2 Date of Birth
mm/dd/yyyy
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Participant 3 Full Name:
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Participant 3 Date of Birth
mm/dd/yyyy
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Open Gym Selection* This field is required.Please select which Open Gym your child(ren) will be attending.
March 14
April 11
May 16
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Parent/Guardian Name:* This field is required.
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Area Code
Phone Number
11
Alternate ContactEmergency Contact, in the event we cannot reach the parent
First Name
Last Name
12
Alternate Contact Phone Number
Area Code
Phone Number
13
Payment
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Open Gym
$26.00Edit
Back
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Quantity
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
Google Pay
After submitting the form, you will be redirected to the Google Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
ACH Bank Transfer
Account Holder Name
14
Terms and Conditions* This field is required.By checking the box and signing below you acknowledge that you have read and accept ALL terms and conditions set forth by Lowcountry Gymnastics, LLC.
15
Liability Waiver & Release, and Assumption of Risk* This field is required. Gymnastics and activities performed as part of Lowcountry Gymnastics involve height and motion. Like any other sport or physical activity, therein occurs the possibility of accidental injury, illness, or even death. While it is our expressed intention to provide for the safety and protection of the child, the parent or guardian, understands and is aware that the possibility of injury is present. Therefore, the parent(s) or guardian(s) agree that Lowcountry Gymnastics, LLC and its staff, or volunteers, shall not be held liable for any injury or damage sustained by the child either before, during, or after participating in his or her scheduled class, camp, party, or any other special event. In consideration of myself or my minor child participating in the Lowcountry Gymnastics, LLC. program, I represent that I understand the nature of this Activity and that I am myself, and my child, are qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in the Activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own or my child’s actions, or inactions, those of others participating in the event or activity, the conditions in which the event takes place, or the negligence of the “releasees” named below; 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, or my child, incur as a result of participation in the Activity. I hereby release, discharge and covenant not to sue Lowcountry Gymnastics, LLC., its respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the “RELEASEES” herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations and further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save and hold harmless each of the Releasees from any loss, liability, damage or cost, which any may incur as the result of such claim
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