2026 Non-Member Waiver/Registration Form

70 Weiss Avenue, West Seneca, NY 14224 716-677-0338

gymnastics-unlimited.net

Non-Member Waiver 2024-25

This form is for those that are not currently enrolled in a class at Gymnastics Unlimited but would like to participate in our open gym programs.

Such as :Private Lessons, Birthday Parties, indoor toddler play or open cheer.
If signing up for open cheer, if the person is under 18 years old, they have to have a parent or guardian sign them in each time.

Today's Date

MonthDayYear
Participants name

Participant first nameParticipant last name
Participants Date of Birth

MonthDayYear
Age:
Are you here for:
What is the birthday child's name & date and time of party?
What is the name of the coach the private is with?
Is participant a minor? (17yrs & under)

Address

House # and Street

Street Address Line 2

City/StateState / Province

Zip
Phone Number

Area CodePhone Number
Email Address:
example@example.com
I am confirming that my date of birth is correct and once I turn 23 years of age, I can no longer participate.
Please initial

Complete parent/guardian information if participant is a minor
Parent/Guardian 1: Name
Address

House # and Street

Street Address Line 2

City/StateState / Province

Zip
Phone #

Area CodePhone Number
Email Address: #1
example@example.com
Parent/Guardian 2: Name
Phone #

Area CodePhone Number
Email Address: #2
Since my child is a minor, I know that I have to sign them in each time they attend open tumbling or open cheer

Emergency Contact Name: (MUST HAVE FOR ALL PARTICIPANTS)
Name:
Emergency Phone Number

Area CodePhone Number

HEALTH INFORMATION

All of the following statements on this page must be initialed or answered.
The Gym relies on the parent or legal guardian's judgment regarding the child's ability & health to participate in the sport/activity.
My child (or I have, if not minor) has medical insurance:
Does your child (or do you, if not a minor) have any behavioral, health or physical limitations/issues that may affect participation?

If yes. please explain

ATHLETE'S RELEASE/PERMISSION FOR MEDICAL TREATMENT
Participation is entirely his or her own choice and with the understanding of risk of accidental injury involved in any activity involving unusual motion or height. If a minor, the parents acknowledge that they know of this injury risk the minor is assuming. In the event of an emergency requiring medical attention, I here by grant permission to the personnel at Gymnastics Unlimited to administer first aid and/or physician or other hospital personnel designated by the Gymnastics Unlimited to attend my son/daughter (or ward)
Participant attending the gym and using the facilities, does so at his or her own risk, the Gym operator, administrators, coaches & staff shall not be liable for any damage arising from personal injuries sustained by participant in or about the premises. Participant assumes full responsibility for all injuries and damages which may occur in or about the premises and he or she does hereby fully and forever release and discharge the gym operator, all associated gyms, their owners, employees, and agents from any and all claims, demands, damages, rights of action, present or future, resulting from or arising out of the participants use of the gym and/or its facilities.
I have read this release form regarding "open times" at Gymnastics Unlimited. I agree to follow all rules understand that there is an assumption of risk involved with participating in the sport of gymnastics. I agree not to hold Gymnastics Unlimited, its officers, agents or instructors responsible for any damages, injuries, illnesses, disabilities or even death which may occur with my association to Gymnastics Unlimited. I will give notice of any injury that may limit participation. I understand and give permission for medical treatment to initiated by Gymnastics Unlimited. I understand policies may change without prior notice, but notice will be on our website.
Please print parent/legal guardian/your name if not a minor
signature
date

MonthDayYear
Date
Should be Empty:

HEALTH INFORMATION

ATHLETE'S RELEASE/PERMISSION FOR MEDICAL TREATMENT