Ned Gymmies Movement Class Waiver

NED GYMMIES
MOVEMENT CLASS WAIVER

Inspired Movement, LLC DBA Ned Gymmies •
PO Box 3800, Nederland, CO 80466 •
nedgymmies@gmail.com
www.nedgymmies.com

STUDENT INFORMATION

STUDENT

Full Name*

First NameLast Name

DOB*

Date

PARENT/GUARDIAN INFORMATION (IF UNDER 18)

Full Name

Relationship to Student

Phone Number

EMERGENCY CONTACT

Full Name*

Relationship*

Phone Number*

Please describe any allergies, chronic illness, physical or medical conditions that may limit your/your child's participation *

CONSENT AND ASSUMPTION OF RISK

ASSUMPTION OF RISK

I am the parent/guardian of the named participant on this document. I recognize that severe injuries, including permanent paralysis or death, can occur in sports or activities involving height or motion; those activities include but are not limited to tumbling, movement education, gymnastics, dance, and apparatus use. I also realize that I/my child will be performing and training in various activities and gymnastics events and utilizing a variety of training devices in doing so. I certify that I have consulted a physician, to the extent that I deem appropriate, concerning I/my child’s participation in these activities. I represent to Inspired Movement LLC, DBA Ned Gymmies (“NG”), that I/my child is medically fit to participate. I recognize that due to increased movement, height, flipping, inversion, and twisting, the competitive pursuit of these sports and activities carries a higher degree of risk of catastrophic injury than do recreational versions.

CONSENT AND ASSUMPTION OF RISK

Being fully aware of the above-listed dangers, I hereby give consent for myself/my child to participate in all NG programs for which they are registered. I ACCEPT all risks associated with this participation.

I have read and agree to the Consent and Assumption of Risk.

Please initial*

WAIVER AND RELEASE

WAIVER AND RELEASE

In consideration for my or I/my child’s participation, I hereby, for myself and my child and our respective heirs and successors, PROMISE NOT TO SUE AND FOREVER RELEASE AND DISCHARGE both NG and Teens Inc., as well as their officers, directors, shareholders, employees, contractors, teachers, coaches and volunteers from all liability resulting from damages or injuries incurred as a result of participation in NG programs, including those resulting from acts of negligence. I understand the NG and Teens Inc. has relied upon this agreement in determining the extent of insurance to be attained and that in the absence of this release, NG would charge significantly higher tuition.

I have read and agree to the Waiver and Release.

Please initial*

PHOTO AND MEDIA RELEASE

PHOTO AND MEDIA RELEASE

I am aware that individual or group publicity photos and videos may be taken from time to time and in consideration for my/my child’s participation, I grant permission for my/my child’s likeness to be used in NG publicity, media usage including but not limited to social media, training tools, and videos and/or advertising.

I have read and agree to the Photo and Media Release.

Please initial*

MEDICAL RELEASE AND AUTHORIZATION

MEDICAL AUTHORIZATION

In the event of an accident or emergency, I hereby authorize NG and its representatives, including its employees, contractors, teachers, coaches, and volunteers, to render first aid to myself/my child to the extent that they deem appropriate. I further authorize NG and its representatives to transport or arrange for transportation by ambulance, if NG deems it appropriate, of myself/my child to a hospital for other medical or dental treatment. Additionally, I hereby agree to be personally responsible for payment of all medical and dental expenses, including transportation, which may be incurred by myself on behalf of myself/my child as a result of any injury sustained while participating at or for NG, including future medical or dental expenses related to such injury.

I have read and agree to the Medical Release.

Please initial*

PROGRAM POLICIES AND TERMS

PAYMENT POLICY

Payment for each drop-in class or session is due before class begins. You will be sent a confirmation email with payment options.

HOLIDAYS AND OTHER CLOSURES

NG will NOT hold classes on major holidays including Thanksgiving, Christmas, Labor Day, Memorial Day, President's Day, Easter Sunday, and the 4th of July. You will be notified by email or text if classes will be canceled on other dates or in the case of the instructor not being able to teach.

If NG needs to close for any reason or a schedule change needs to be made, due to unforeseen circumstances, or any other reason deemed necessary by the staff of NG or Teens Inc., we reserve the right to do so. If NG or Teens Inc. is closed for any reason other than a scheduled holiday, a make-up day will be offered or a refund given at the discretion of NG.

NG and Teens Inc.’s management reserves the right to cancel a scheduled class due to a lack of participation or a conflict with another class or event. NG will make every effort to avoid interrupting classes and accommodate our students. Where appropriate, refunds will be issued in such events.

MAKE-UPS

Due to the nature of our programming, we are unable to offer in-session makeup classes. Instead, if you are enrolling in the next session, you may carry over one makeup class per participant over to the next session. If you paid for the full session and need to make up a class, please notify us and you will receive a credit on the next session's tuition of $20. Make-ups cannot be carried over beyond the subsequent session.

COVID & OTHER ILLNESS

Do not allow you/your child to attend class if exposed to COVID-19 in the past 14 days.

Participants must be free of fever, without the aid of medication, for a minimum of 24 hours before participating in an NG class or event. If you/your child has been sick in the last 24 hours, please do not come to class. Furthermore, if you or your child has stayed home from school due to illness, have had yellow/green mucus, vomited, or had diarrhea in the past 24 hours do not bring them to class. Similarly, we also ask that you do not bring sick siblings to Teens Inc.

RESPONSIBILITIES

I am responsible to notify NG staff if my email, physical address, or phone number(s) changes.

I am responsible to pay for each class/session in full before it starts as outlined above.

I am responsible to ensure that I/my child comes to class in good health and free of injury. Any physical injuries or special needs will be disclosed to the teacher before participation in classes.

I have read and agree to the Program Policies and Terms.

Please initial*

I agree to also complete the Teens Inc. waiver before I/my child attends class. The Teens waiver will be emailed to me so I can print it, fill it out and bring it to my/my child's first class. This form only needs to be completed once.

Please initial*

CONFIRMATION

By entering the information 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.

Parent/Guardian Full Name*

First NameLast Name

Parent/Guardian Signature*

Type your name here as your electronic signature

Confirmation E-mail*

example@example.com

After completing this form, please click the Submit Registration button. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at nedgymmies@gmail.com.