Clone of Gymnastics Spring 2026 Registration Form

This will be open for 2 year olds through 5th graders. Registration will be $40 per month, your child's spot will not be secure until the Registration fee has been paid. Deadline to register is August 26th or when spots are full. You will need to provide your child with a water bottle each day. Please call the office at 478-625-3383 if you have any questions. Class will be on Mondays.

2 year olds (30min) Full at this time.

3&4 year olds (45min)

5-7 year olds (45mins)

8 & Up (45min) - Full at this time.

Please call the office to be added to the wait list.

Gymnast Information

Athlete's Name

First NameLast Name

Birth Date

MonthDayYear

Age

Age Group

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Information

Name

First NameLast Name

Cell Number

Area CodePhone Number

E-mail

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Name

First NameLast Name

My Products

1st Month Registration$40.00

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Jefferson County Recreation Department during the gymnastics camp. In exchange for the acceptance of said child’s candidacy by Jefferson County Recration Department, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Jefferson County Recreation Department, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Jefferson County Recreation Departmetn, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities. Refunds will only be issued if the Recreation Department has to cancel the season.

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the Jefferson County Recreation Department and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Spring Gymnastic Registration

My Products*

My Products