THE ROCHESTER GYMNASTICS ACADEMY

BIRTHDAY PARTY REGISTRATION FORM

131 Despatch Drive , East Rochester , NY, 14445

PHONE: (585) 248-3750

FAX: (585) 248-3757

PARTY INFORMATION

 

Guest Name      Guest Age   
Address      City   
State        Zip       Phone   

 

Children will participate in obstacle courses, climbing wall, inflatable castles, games and activities including the use of our in ground pit and trampolines.  Our Adult instructor / coaches are highly qualified experienced and expert instructors.  All staff has a competitive background including Bulgarian Olympic and National Team members as well as collegiate scholarship competitors.

 

Please note that NO child will be allowed to participate in the birthday party without a signed registration and participation agreement.

 

If you have further questions, please feel free to call us at (585) 248-3750 and ask to speak to Emma. Please leave a message, as I may be teaching or coaching.  Alternatively, feel free to send me an e-mail with any questions and/or concerns.

    
Participation Agreement  (To be signed by participant and parent / guardian) 
 

I, ___________________________________, parent/guardian of ____________________________________ give permission for said son/daughter to participate in gymnastics and/or cheerleading training at ROCHESTER GYMNASTICS ACADEMY , and, if applicable, my son's/daughter's participation in competitions and events individually or as a team member of ROCHESTER GYMNASTICS ACADEMY .  I understand that gymnastics is a sport that involves risks, including risk of catastrophic injury, paralysis and even death, as well as other damages and losses associated with the participation in gymnastics training and events.  I attest to my son's / daughter's sound health of mind and body and I authorize ROCHESTER GYMNASTICS ACADEMY to seek medical treatment at the nearest medical facility in case of emergency.  I agree that ROCHESTER GYMNASTICS ACADEMY , along with employees, agents, officers and directors thereof shall not be liable for any losses or damages occurring as a result of my son's / daughter's participation in any such exercises, training, events or competition, except where such loss or damage is the result of the intentional or reckless conduct of ROCHESTER GYMNASTICS ACADEMY or the individuals identified above.

PRIMARY MEDICAL INSURANCE:  
PARTICIPANT'S SIGNATURE:  

 

As legal parent/guardian of the above participant, I hereby certify by my signature below, that I fully understand and accept each of the above conditions for permitting my child to participate in any exercises, training, event or competition at or on behalf of ROCHESTER GYMNASTICS ACADEMY

 
PARENT/GUARDIAN SIGNATURE:   DATE: