DYNASTY MD CHEER AND TUMBLE SUMMER CAMP REGISTRATION
3480 Catteron Pl Suite 3, Waldorf MD 20602
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Address
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example@example.com
Parent/Guardian Phone Number
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Emergency Contact Name
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Athlete Allergies or Restrictions (If none type N/A)
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T - Shirt Size
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Please Select
YS
YM
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AL
Please list all authorized adults that can pick up your child. If this list changes you must notify the front desk immediately at dynastymaryland@gmail.com. If someone has to pick up your child that is not on this list you must email dynastymaryland@gmail.com before pick up.
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As the parent, guardian and/or participant , I understand and acknowledge that the activities that I or my child engage in while on the premises or under the auspices of Maryland Ntensity Cheer and Dynasty Spirit Elite pose known and unknown risks which could result in injury, paralysis, death, emotional distress, or damage to myself, my child(ren), to property, or to any third parties or associates. I expressly agree and promise to accept and assume all the risks, known and unknown, connected with DSE & MNC related activities, including by not limited to tumbling, a performance of stunts and/or use of trampolines and gym equipment. I elect for myself and my children to participate in such activities despite the risks. I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify DSE & MNC including coaches and staff from all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with myself or my child’s participant in DSE & MNC activities. I certify that myself and my child has health, accident, life, and liability insurance to cover bodily injury or property damage that may be caused or suffered while participating in this event or activity, or else I agree to bear the costs of such injury, damage or death to myself and my child. I further certify that I am willing to assume and bear the costs of all risks that may arise or be created, directly or indirectly, through or by any such condition. Finally I understand that any and all fees paid to DSE & MNC are non refundable. No credits or refunds will be given for any reasons.
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The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Maryland Ntensity Cheer & Dynasty Spirit Elite have put in place preventative measures to reduce the spread of COVID-19; however, MNC/DSE cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending MNC/DSE could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending MNC/DSE and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at MNC/DSE may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at MNC/DSE or any associate locations or events. On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless MNC/DSE, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of MNC/DSE, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any DSE/MNC program.
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Todays Date
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Month
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Parent/Guardian Signature
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WEEK SELECTION
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Please Select
WEEK 1: 6/24-6/28
WEEK 2: 7/8-7/12
WEEK 3: 7/15-7/19
WEEK 4: 7/22-7/26
WEEK 5: 7/29-8/2
WEEK 6: 8/5-8/9
WEEK 7: 8/12-8/16
WE ARE CLOSED FROM 7/1-7/5 FOR THE HOLIDAY
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Summer Camp Registration
COST IS PER WEEK!
$
150.00
Non Dynasty Member
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