LemPossible Gymnastics & Cheer Registration Form

Sign up for:				Time			Price
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							Subtotal:_____________________
							     Total:_____________________

Name:__________________________________________________________________

Address:________________________________________________________________

________________________________________________________________________

Parent Name:_____________________________________________________________

Phone Number:___________________________________________________________

Email Address:___________________________________________________________

I HERBY ACKNOWLEDGE THAT I HAVE BEEN INSTRUCTED BY LEMPOSSIBLE GYMNASTICS AND CHEER THAT ANY ACTIVITY INVOLVING HEIGHT AND MOTION MAY RESULT IN PHYSICAL INJURY TO MY CHILD INJURIES WHICH COULD RESULT IN PARALYSIS.  I HAVE BEEN ASSURED THAT ALL PRECAUTIONS HAVE BEEN AND WILL BE REASONABLY UNDERTAKEN BY LEMPOSSIBLE GYMNASTICS AND CHEER TO INSURE MY CHILD'S SAFETY.  IN THE EVENT OF AN ACCIDENT I HERBY WAIVE AND RELEASE LEMPOSSIBLE GYMNASTICS AND CHEER FROM ANY AND ALL CLAIMS OF LIABILITY WHILE MY CHILD IS ON THE PREMISES OF THE FACILITY OR ON A PLANNED TRIP TO A GYMNASTICS/CHEERLEADING COMPETITION.  I UNDERSTAND THAT IT IS MY/OUR RESPONSIBILITY TO PROVIDE FOR MEDICAL INSURANCE.

THIS RELEASE/WAIVER OF LIABILITY HAS BEEN THROUGHLY READ AND UNDERSTOOD BY ME AND I VOLUNTARILY SIGNED AS TO ITS INTENT AND CONTENT.

THIS THE _______________ DAY OF _______________, _______________ (year).

Parent/Guardian Signature:__________________________________________________