Impulse Elite Liability Waiver and Agreement Form
Participant's Information
Participant's Name
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First Name
Last Name
Date of Birth
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-
Month
-
Day
Year
Date
Medications / Allergies / Medical Conditions
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Will there be other participants joining?
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Yes
No
Parent/Guardian's Name
*
First Name
Last Name
Email Address
*
example@example.com
Emergency Phone Number
*
Please enter a valid phone number.
Alternative Phone Number
*
Please enter a valid phone number.
Policy Agreement
I give permission for my child to participate in all Kids Camp activities at Impulse Elite, including group-led enrichment, movies, outdoor play, and more. I also consent to my child being included in photos or promotional materials that may be shared on Instagram, Facebook, and other social media platforms. I understand that all account balances must be paid in full for my child to participate. We’re excited to create a fun and memorable experience for them!
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I have read, understand, and agree to all the policies outlined.
Liability Waiver
I agree to participate (or allow my child(ren) and family members to participate) in Impulse Elite Cheer, and hereby release Impulse Elite Cheerleading LLC, its directors, officers, agents, coaches, and employees from liability for any injury that might occur to myself (or to my child(ren) and family members) while participating in the Impulse Elite Cheer program, including travel to and from training sessions, or other scheduled organization activities. I agree to indemnify and hold harmless the above mentioned organizations and/or individuals, their agents and/or employees, against any and all liability for personal injury, including injuries resulting in death to me, my child(ren) and/or other family members, or damage to my property, the property to my child(ren) and/or other family members, or both, while I (or my child(ren) or family members) participating in the Impulse Elite Cheer program and other classes.
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I have read, understand, and agree to all the policies outlined.
Treatment Authorization
I certify that I am the parent or legal guardian for my child(ren). I hereby give my permission for any supervisor, coach or other team administrator associated with the Impulse Elite Cheer to seek and give appropriate medical attention for our child(ren) in the event of an accident, injury, illness. I will be responsible for any and all costs associated with any necessary medical attention and/or treatment. I hereby waive, release and forever discharge Impulse Elite Cheerleading LLC from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in Impulse Elite Cheer activities, whether or not damages or loss is due to negligence. I hereby acknowledge that my children is (are) physically fit and capable of participation in all activities.
*
I have read, understand, and agree to all the policies outlined.
Parent's/Guardian's Signature
*
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