In order to participate in open gym/free play,
t
he following information must be read and signed.
Name of Participant
Birthdate
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Contact Phone
Format: (000) 000-0000.
Check Boxes
I give permission for my child to participate in open gym at Badlands Gymnastics
I understand that gymnastics involves risk and can be dangerous
I understand that any activity involving motion or height can cause serious injury
The above named participant has had an examination in the last 12 months and it physically, mentally and emotionally capable of participating in athletic activities
Participants are expected to carry their own medical insurance agree to be responsible for any medical bills incurred resulting from illness or an injury, while my child is at Badlands Gymnastics
In the event of illness or injury, every effort will be made to contact the parent or guardian.
If necessary, I authorize staff at Badlands Gymnastics to administer first aid or authorize treatment
Parent Printed Name
Parent Signature
Date
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: