May 2026 Open Gym Registration

Open Gym Registration and Release

May 2026
PLEASE NOTE: This form must be completed by the parent/guardian of the individual participating in open gym.

Tickets

Please select ticket quantity below: Please purchase one ticket for each child who you would like to have attend open gym. Pricing for 90 minutes of playtime is $25 for one child and $15 for each additional child.

Sunday 5/31 10:30-12:00pm in Natick$25.00

Quantity
Item subtotal:

Enter coupon

Total $0.00

Please provide the requested information for all children who will be attending open gym
Child 1 name

First NameLast Name
Child 1 Date of Birth:

MonthDayYear
Child 1 Allergies
Child 1 Medical Precautions
Which open gyms will this child be attending? (please check all that apply based on the tickets that you purchased above)
Child 2 name

First NameLast Name
Child 2 Date of Birth:

MonthDayYear
Child 2 Allergies
Child 2 Medical Precautions
Which open gyms will this child be attending? (please check all that apply based on the tickets that you purchased above)
Child 3 name

First NameLast Name
Child 3 Date of Birth:

MonthDayYear
Child 3 Allergies
Child 3 Medical Precautions
Which open gyms will this child be attending? (please check all that apply based on the tickets that you purchased above)
Child 4 name

First NameLast Name
Child 4 Date of Birth:

MonthDayYear
Child 4 Allergies
Child 4 Medical Precautions
Which open gyms will this child be attending? (please check all that apply based on the tickets that you purchased above)

Contacts and Release
Primary contact in case of emergency

First NameLast Name
Primary emergency contact phone number

Area CodePhone Number
Email
example@example.com
Secondary contact in case of emergency

First NameLast Name
Secondary emergency contact phone number

Area CodePhone Number
Our policy is to call 911 in the case of any medical emergency. Please indicate if you would like us to do otherwise, and what action you would like taken:
In the case of an emergency, it is likely that your child will be transported to Newton-Wellesley Hospital. If you prefer that your child be taken to a different hospital or facility, please indicate below.
Open gyms at the Boston Ability Center include the presence of two staff members who facilitate free play and assist families in accessing the gym space and equipment. Open gyms are not a drop-off event. As such, we ask that a parent or caregiver accompany each child at all times to provide individual supervision, ensure safety, and facilitate use of equipment. Please feel free to speak with a BAC staff member if you have any questions or need assistance during the event!
I, the undersigned parent or legal guardian of the above-named child, give permission for my child to participate in Open Gym at the Boston Ability Center.

I understand that Open Gym at the Boston Ability Center is an unstructured, recreational activity that may include the use of therapy/gym equipment, therapy tools, and play structures. I acknowledge that participation in physical activities carries inherent risks, including but not limited to falls, collisions, and other injuries.

I certify that my child is physically able to participate and does not have any medical condition that would prevent safe participation, or that I have disclosed any such conditions to Boston Ability Center staff.

In consideration of my child being allowed to participate, I agree to the following:
1. Assumption of Risk - I knowingly and voluntarily assume all risks and responsibility associated with my child’s participation in BAC summer camp activities.
2. Release of Liability - I release, waive, and discharge the Boston Ability Center, its owner, employees, therapists, other staff, and any partners of the program from any and all liability, claims, demands, or causes of action arising out of or related to any injury, loss, or damage that may occur during participation.
3. Rules and Conduct - I agree that my child and I will follow all posted rules and staff instructions. Failure to do so may result in removal from the activity.
I certify that all of the information provided on this application is correct and true to the best of my knowledge.
Signature of Parent/Legal Guardian:
Name of Parent/Legal Guardian:

First NameLast Name
Date:

MonthDayYear

Photo and Video Consent Form

(optional)
I hereby grant The Boston Ability Center permission to use my child’s likeness in a photograph or video in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of The Boston Ability Center and will not be returned. I hereby irrevocably authorize The Boston Ability Center to edit, alter, copy, exhibit, publish or distribute photos or videos for purposes of publicizing The Boston Ability Center’s programs or for any other lawful purposes. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein the likeness of my child appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of photographs or videos. I hereby hold harmless and release and forever discharge The Boston Ability Center from all claims, demands, and causes of action which I, my heirs, representatives, administrators, or any other persons acting on my child’s behalf may take.
Parent/Guardian Signature
Parent/Guardian Printed Name
Date

MonthDayYear
Date

Payment

Please enter credit card information below:
IMPORTANT NOTE!

All Open Gym ticket sales are non-refundable and non-transferable.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Open Gym Registration and Release

Tickets

Please select ticket quantity below: Please purchase one ticket for each child who you would like to have attend open gym. Pricing for 90 minutes of playtime is $25 for one child and $15 for each additional child. *

Please provide the requested information for all children who will be attending open gym

Contacts and Release

Photo and Video Consent Form

Payment

Payment Methods

Please select ticket quantity below: Please purchase one ticket for each child who you would like to have attend open gym. Pricing for 90 minutes of playtime is $25 for one child and $15 for each additional child.