Youth Holiday Camp Registration Form : MSA & Circus Arts

Camp Registration And Signup

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Age
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Student Email (if applicable)(valid email required)
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Previous training, skills and or experience
List of physical limitations
Does the student student suffer from allergies, hay fever, epilepsy, or any other disability, including sports injuries which you feel the staff should know about?
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Parent/Guardian
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Camp Session
Winter Camp
Day1 Dec.26 Day 2 Dec.27
If weekly or daily, please list dates
How did you hear about us?
Agreement, Information, Waiver and Release FormMeirmanovs Sports Acrobatics & Circus ARTS Meirmanov SportsAcro & Circus ARTS Agreement, Information, Waiver and Release Form Athletes Agreement: In considerations of my membership to Meirmanovs SportsAcro and Circus ARTS, my participation in Meirmanovs SportsAcro & Circus ARTS classes, events, competitions and activities events. I agree to be bound by each of the following: - Ready to Participate: I will only participate in those Meirmanovs SportsAcro & Circus ARTS classes, events, competitions and activities for which I believe I am physically and psychologically prepared. Prior to participation I will have practiced my exercise and will preform only those exercises which I have accomplished to the degree of confidence necessary to assure I can perform them by myself, and without injury.n- Healthy and Fit: I have had a physical examination by a licensed physician within the last 1-3 years and I can exercise without medical supervision. I can exercise without medical supervision. If I have health issues or a history of any health issues I must inform the Merimanov SportsAcro staff, and have a pre-participation physical or examination by a licensed physician, and my physician will be involved in all return to activity decisions before I will participate.n- Medical Attention: I hereby give my consent to Meirmanov SportsAcro & Circus ARTS staff members to provide, through medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted in the course of my participation.n- Primary Medical Insurance: I am covered by a primary health, medical, accidental insurance policy.n- Waiver and Release: I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis and even death, as well as others damages and losses associated with participation in gymnastics activities and events. I further agree Meirmanov SportsAcro, USA Gymnastics, Meirmanov SportsAcro & Circus ARTS staff members and the sponsor of any Meirmanov SportsAcro, USA Gymnastics events, along with the employees, agents, offices and directors of these organizations shall not be liable for any losses or damages occurring as a result of my participation in the event. Parents Agreement: I fully understand that Meirmanov SportsAcro, USA Gymnastics, Meirmanov SportsAcro & Circus ARTS staff members are not physicians or medical practitioners of an kind. With the above in mind, I hereby release the Meirmanov Sports Acro, USA Gymnastics, Meirmanov SportsAcro & Circus ARTS staff to render first aid to myself or my child/children in the event of any injuries or illness, and if deemed necessary by the Meirmanov SportsAcro, USA Gymnastics, Meirmanov SportsAcro & Circus ARTS staff members to call a doctor and seek medical help, including transportation by a Meirmanov SportsAcro, USA Gymnastics, Meirmanov SportsAcro & Circus ARTS staff members or its representatives, whether paid or volunteer, to any health care facility or hospital, or calling of an ambulance for said child should Meirmanov Sports Acro, USA Gymnastics, Meirmanov SportsAcro & Circus ARTS staff members deem this necessary. Meirmanov SportsAcro, USA Gymnastics, Meirmanov SportsAcro & Circus ARTS staff recognize their obligation to make their students and their parents aware of the risks and hazards associated with the sport of gymnastics, including women’s, men’s rhythmic, sports acrobatics, trampoline, tumblings, cheerleading, circus arts, fitness and dance. Students may suffer possibly minor, serious or catastrophic in nature. Gymnastics, including women’s, men’s rhythmic, sports acrobatics, trampoline, tumbling, cheerleading, circus arts, fitness and dance can be dangerous and can lead to injury. I am aware of the risks and hazards associated and will make my child/children aware of the possibility of injury and will encourage my child/children t follow all safety rules and coach’s instructions. Meirmanov SportsAcro, USA Gymnastics, its coaches and other staff members, will not accept responsibility for injuries sustained by any student during the course of gymnastics, including women’s, men’s rhythmic, sports acrobatics, trampoline, tumbling, cheerleading, circus arts, fitness and dance instruction, or open workouts or in the case of any exhibition, competition or clinic in which he or she may participate including while traveling to or from an event. With the above in mind, and being fully aware of the risks and possibility on injury involved, I consent to have my child participate in the program offered by Meirmanov SportsAcro and USA Gymnastics. As legal parent/guardian of an athlete under 18, I hereby verify by my electronic signature below that I fully understand and accept each of the above conditions for permitting my child to participate in class events, competitions and activities conducted by Meirmanov SportsAcro, USA Gymnastics. I, my executors or other representatives, waive and release all rights and claims for damages that I or my child may have against Meirmanov SportsAcro, USA Gymnastics, Meirmanov SportsAcro & Circus Arts staff members, i s representatives whether paid or volunteer. I also affirm that I have and will continue to provide proper hospitalization, health/accident coverage which I consider adequate for my/my child’s protection. I also understand that its the parent’s responsibility to warn the child about the dangers of gymnastics and injury. I will warn my child/children according to what I feel are appropriate. Meirmanov SportsAcro, USA Gymnastics, will only warn the child through “safety messages”, teaching style and progressions.
BY CLICKING ON ACCEPT, I AM STATING THAT I HAVE READ THIS INFORMATION, AGREEMENT, WAIVER AND AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY ACCEPTING IT, AND ACCEPT IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
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