Summer Camp Registration Form

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Parent Name* This field is required.
First Name
Last Name
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E-mail* This field is required.
example@example.com
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Mobile Number* This field is required.
4
Alternate Phone NumberIn case we can not reach the parent
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
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Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
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Hungary
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India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Child 1 Name* This field is required.
First Name
Last Name
7
Date of Birth* This field is required.
Birthday Child's Date of Birth
Month
Day
Year
8
Child 2 Name
First Name
Last Name
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Child 2 Date of Birth
Birthday Child's Date of Birth
Month
Day
Year
10
Child 3 Name
First Name
Last Name
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Child 3 Date of Birth
Birthday Child's Date of Birth
Month
Day
Year
12
Special Needs:Please let us know if your child has any special needs, allergies, medications, etc.
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Image FieldSummer Camps
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1/2 Day Camps (9am-12pm)* This field is required.Select 'NONE' if you are not registering for any 1/2 Day Camps
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Full Day Camps (9am-4pm)* This field is required.Select 'NONE' if you are not registering for any Full Day Camps
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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.
17
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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ORDER SUMMARY
Total costUSD
1/2 Day Camps
1/2 Day Camps (M-F; 9a-12p). Buy 4 and get 1 Summer Open Gym FREE, Buy all 9 and get all 3 Summer Open Gyms FREE
$130.00Edit
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Quantity
1 Full Day Camp
Buy 1 Full Day Camp (M-F; 9a-4p) for $200
$200.00Edit
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Quantity
2 Full Day Camp Bundle
2 Full Day Camps (M-F; 9a-4p)
$385.00Edit
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Quantity
4 Full Day Camp Bundle
4 Full Day Camps (M-F; 9a-4p)
$760.00Edit
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6 Full Day Camp Bundle
6 Full Day Camps (M-F; 9a-4p)
$1,110.00Edit
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8 Full Day Camp Bundle
8 Full Day Camps (M-F; 9a-4p)
$1,400.00Edit
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9 Full Day Camp Bundle
9 Full Day Camps (M-F; 9a-4p) + All 3 Summer Open Gyms FREE
$1,575.00Edit
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Total cost $0.00
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