WORLD EXTREME STUNTS AND TUMBLING REGISTRATION FORM
Please Complete and submit the form below. If you have any questions or concerns, please contact us at (850)582-4557
Parent's Full Name:
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State
Post Code
E-mail
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example@example.com
Phone Number
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Format: (000) 000-0000.
Child's Full Name
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First Name
Last Name
Date of Birth:
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-
Day
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Month
Year
Date
Age in Years
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School Grade
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Please Select
PREP
1
2
3
4
5
6
7
8
9
10
Gender
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Female
Male
Notes to Admin:
Has your child done Gymnastics, or Cheerleading before?
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Yes
No
Previous Club Name & Current Level/Class & Year attended
How did you hear about us?
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Family
Friends
Facebook
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Internet
Magazine
Other
WORLD EXTREME STUNTS AND TUMBLING LLC, offers 4 levels of Tumbling classes, with instruction from Gabe West, Jana Williamson and assistant Macie Wallace. 3–4-year-old Tumbling Beginner, Tumbling Intermediate, Tumbling Advanced Tumbling. Level placement in the program will be at the coach's discretion. Previous experience and current skill level will be considered when placing each student. You may be asked to move up or down into different classes from the initial placement, this will affect class times. You may request a specific class time/level but placement in the requested class is not guaranteed.
Beginner Tumbling
Intermediate Tumbling
Advanced Tumbling
3 & 4 year old Tumbling
WORLD EXTREME STUNTS AND TUMBLING LLCRelease of Liability & Voluntary Assumption of Risk I, _______________________, the parent and/or legal guardian of the Participant/Minor Participant (the “Guardian”), as material consideration for ________________________, a participant UNDER the age of 18 (the “Minor Participant" or the “Minor”), being allowed to participate in cheerleading, gymnastics, tumbling, dance and other athletic instruction, practice and competition (“Activity”) with WORLD EXTREME STUNTS AND TUMBLING LLC expressly and freely agrees as follows:1. Guardian is allowing the Minor to participate in the Activity. Guardian acknowledges that Guardian has authority to immediately terminate the Minor’s participation in the Activity if the Guardian observes anything deemed unsafe and agrees to immediately alert the WORLD EXTREME STUNTS AND TUMBLING LLC management of any such observations.2. Guardian represents that the Minor is in good health and does not have any health or mental/physical impairments or conditions that would be aggravated by participating in the Activity or that make such participation unsafe or otherwise inappropriate for the Minor, or other participants. Guardian further acknowledge and understand that the Guardian will be responsible for any and all medical and related bills that may be incurred on behalf of the Minor for any illness or injury that the Minor may sustain during or as a result of the Activity and while traveling to and from the site of WORLD EXTREME STUNTS AND TUMBLING LLC Gym or any other sites for the Activity including but not limited to camps, clinics, competitions or and other cheerleading or dance activity.3. Guardian WAIVES, RELEASES and FOREVER DISCHARGES any and all claims, liabilities, loss, demands, damages, costs, expenses, lawsuits, causes of action and judgments that he or she, the Minor, or any other parent/guardian of the Minor now or hereafter may have or claim to have against WORLD EXTREME STUNTS AND TUMBLING LLC and their respective Owners, Subsidiary Companies, Insurers, Directors, Officers, Employees, Staff, Volunteers, Agents, Successors and Assigns (collectively, the “WORLD EXTREME STUNTS AND TUMBLING LLC”) resulting from any Inherent Risk involved with the Activity. The term “INHERENT RISK” shall mean those dangers or conditions, known or unknown, which are characteristic of, intrinsic to, or an integral part of the Activity and which are not eliminated even if the Activity provider acts with due care in a reasonably prudent manner. Examples of such INHERENT RISKS include, but are not limited to: sprains, strains, cuts, bruises, broken bones or other physical injuries, including injury resulting from negligent or intentional acts of the Minor or other minor participants and/or more serious injuries or illness. INHERENT RISKS additionally include a failure by the Activity provider to warn Guardian or Minor of a specific INHERENT RISK. Guardian acknowledges, understands, and appreciates that there are INHERENT RISKS involved in the Activity.4. Guardian RELEASES and HOLDS WORLD EXTREME STUNTS AND TUMBLING LLC HARMLESS from and against any claims, actions, damages, demands, costs, expenses (including attorneys’ fees ) or lawsuits, whether foreseen or unforeseen, present or future, known or unknown, that the Minor, the Guardian, or any other parent/legal guardian of the Minor may have or assert as arising from the INHERENT RISKS of the Activity, including those for personal injuries, illness, death or damage to or loss of property .5. In the event the Minor is injured while participating in the Activity or under the supervision of WORLD EXTREME STUNTS AND TUMBLING LLC, Guardian hereby authorizes WORLD EXTREME STUNTS AND TUMBLING LLC and/or its employees to obtain necessary medical treatment for the Minor6. This Waiver and Release is intended to be only as broad and inclusive as permitted by Florida Statute Section 744.301. Any court interpreting this Waiver and Release shall construe the same as being only as broad and inclusive as permitted by such statute. NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN PURSUANT TO FLORIDA STATUTE SECTION 744.301 READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE RELEASED PARTIES AND THEIR PARENTS SUBSIDIARIES, INSURERS, DIRECTORS, OFFICERS, EMPLOYEES, VOLUNTEERS, AGENTS, SUCCESSORS AND ASSIGNS USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM THE RELEASED PARTIES AND THEIR PARENTS SUBSIDIARIES, INSURERS, DIRECTORS, OFFICERS, EMPLOYEES, VOLUNTEERS, AGENTS, SUCCESSORS AND ASSIGNS IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE RELEASED PARTIES (AND ITS EMPLOYEES, VOLUNTEERS, AGENTS) HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. I HAVE READ AND UNDERSTAND THE FOREGOING WAIVER AND RELEASE AND ACCEPT AND AGREE TO ITS TERMS.
(PARENT OR GUARDIAN) I understand my typed name at the bottom of this form constitutes agreement to the terms of the wavier.
(Student Athlete) I understand my typed name at the bottom of this form constitutes agreement to the terms of the wavier.
RULES: 1. PROPER ATTIRE: Leotard or bodysuit, footies or barefoot, hair tied back or pinned up. Shorts and t-shirts are acceptable for girls. Boys– stretch shorts & t-shirt (not baggy). 2. BE ON TIME: Both coming & going. Do not enter the main area until your class time. 3. ABSENCES: Absences should be limited to illness or family emergencies, not parties or other activities. If you cannot attend a lesson, and notify us prior to the lesson time, a make-up session could possibly be scheduled (depending on the nature of that week’s lesson.) Make-ups should be completed within 30 days of the missed class. Consistent attendance in your own class provides the best results. WORLD EXTREME STUNTS AND TUMBLING LLC is very proud of our students. We wish to help your child attain whatever goals she/he has and provide you with the most professional training on a personal level at the most affordable price. Our goals—in order are: Safety first, Fun second, followed by Skill Progression. Any activity involving height or motion incurs the possibility of accidental injury. While it is our express intention at WORLD EXTREME STUNTS AND TUMBLING LLC, to provide for the safety and protection of your child, it is expressly asserted that WORLD EXTREME STUNTS AND TUMBLING LLC, shall not be held liable for any injury sustained while your child is under our instruction, supervision, or control. WORLD EXTREME STUNTS AND TUMBLING LLC has permission to use any photos taken of my child while he/she is participating in any program at WORLD EXTREME STUNTS AND TUMBLING LLC.
(PARENT OR GUARDIAN) I understand my typed name at the bottom of this form constitutes agreement to the terms of the rules and regulations.
(Student Athlete) I understand my typed name at the bottom of this form constitutes agreement to the terms of the rules and regulations.
Please make payments ASAP to guarantee your athletes spot, as spaces are limited.
If you have another way of payment please put notes in the additional notes space.
Additional Notes
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