The Peach Pit Collier Road Birthday Waiver

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Participant Name* This field is required.
First Name
Last Name
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Participant Date of Birth* This field is required.
Date
Month
Day
Year
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Choose the party you are attending* This field is required.
Please Select
Please Select
10/4 Parker Givens (3)
10/4 Emmy Bedell (6)
10/4 Maggie Olson (8)
10/4 Luca (7)
10/5 Winne (5) Jude (3)
10/5 Lulu Thomspon (4)
10/5 Atlas Benjamin (4)
10/5 Ravit Stanton (5)
10/5 June Vermeulen (6)
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Parent/Guardian Name* This field is required.Name of Parent/Guardian Completing this Form
First Name
Last Name
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Email Address* This field is required.
example@example.com
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Participation Waiver* This field is required.I, either in my individual capacity and on my own behalf if I the participant and am 18 years or older, or on behalf of my child(ren), any child(ren) whose activities I oversee on behalf of their parents or legal guardians, any child(ren) upon which I have been appointed legal guardian, or any parents, heirs, assigns, personal representatives, and/or any child(ren) upon which I have authority to execute this Agreement (all herein collectively the “Participant(s)”), am executing this Agreement to participate in the services offered by The Peach Pit by YES Brands, LLC, The Peach Pit Gymnastics, LLC, and any of its owners or subsidiaries. In consideration of the services of The Peach Pit by YES Brands, LLC, The Peach Pit Gymnastics, LLC, and any of its owners or subsidiaries, its owners, agents, officers, employees, and all other persons or entities acting in any capacity on their behalf (herein collectively "The Peach Pit,"), the Participant(s) hereby agree to release, discharge, and hold harmless The Peach Pit, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows: 1. I understand and acknowledge that the activities the Participant(s), participate in while on the premises or under the auspices of The Peach Pit pose known and unknown risks which could result in injury, paralysis, death, emotional distress, or damage to the Participant(s) and/or (including, but not limited to emotional distress) any family member of the Participant(s), me, my child, to property, or to third parties. The following describes some, but not all, of those risks: Cheerleading, dance, and gymnastics, including performances of stunts and use of trampolines and foam pits, entail certain risks that simply cannot be eliminated without jeopardizing the essential qualities of the activity. Without a certain degree of risk, cheerleading and gymnastics students would not improve their skills and the enjoyment of the sport would be diminished. Cheerleading and gymnastics expose participants to the usual risk of cuts and bruises, and other more serious risks as well. Participants often fall, sprain or break wrists and ankles, and can suffer more serious injuries. Participants must also sometimes travel to and from shows, meets and exhibitions, and this Agreement shall act as a full disclaimer of any and all liability associated with The Peach Pit relating in any way to such transportation. I hereby acknowledge that if I (and/or any child(ren) upon which I am executing this agreement with full authority) suffer an injury related in any way to The Peach Pit activities, medical assistance may be required which I am financially responsible for as further outlined herein below. 2. I, on my own behalf if I am the Participant and/or on behalf of any child(ren) upon which I am executing this agreement with full authority expressly agree and promise to accept and assume all of the risks, known and unknown, connected with The Peach Pit related activities, including but not limited to performance of stunts and use of trampolines and foam pits. The Participant(s) participation is purely voluntary. No one has forced or coerced the Participant(s) to participate. I elect for the Participant(s) to participate in such activities in spite of the risks. 3. I and the Participants hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify The Peach Pit from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with the Participant(s) participation in The Peach Pit-related activities. 4. Should The Peach Pit be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and reimburse them for such fees and costs. 5. I certify that the Participant(s) has health, accident 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.
I agree.
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