GTC Academy

Parent / Guardian WAIVER AND RELEASE Form

You agree that you are aware of your son or daughter, named below, participating in physical exercise involving gymnastics, trampoline and tumbling which could cause injury to them.

You agree that your son or daughter is voluntarily participating in these activities and is assuming all risks or injury that might result.

You hereby agree to waive any claims or rights that you might otherwise have to sue us, our employees, owners, officers, or agents for injuries that might occur as a result of these activities.

We will make no evaluation or recommendation whether your son or daughter is physically fit for any exercise activity. If your son or daughter has any physical condition that may impair their ability to engage in these activities, it is your responsibility to obtain a physician's statement describing any limitations to participate in this program. It is always advisable to consult your physician prior to undertaking any physical exercise program.

Student's Name:_______________________________ DOB:________

Address:_________________________________________________

City:__________________ State:_________ Zip:____________

Home Phone #:_________________ Emergengy Phone #:_____________

Parent/Gurardian Name:____________________ Relationship: ___________

Parent/Guardian Signature:________________________ Date:___________