CHILD INFORMATION

Child's Name: Gender:  Male Female
Address: Birth Date:
City: Age:
Zip: Grade

CONTACT INFORMATION

Parent 1: Parent 2:
Name: Name:
Work/Cell Phone: Work/Cell Phone:
Email: Email:

EMERGENCY INFORMATION:

Name: Phone Number:
Relationship:
Physician's Name: Phone Number:
Any intolerance to medication:  Yes No
Any medication taken regularly:  Yes No
Does your child have any neurological, sensory, physical, or behavioral issues?  Yes No
If YES, Explain:
Any health conditions that may affect your child’s activity?
How did you hear about us?

Please include a first and second choice for classes in the case that the first is not available

First Class Choice: Day: Time:
Second Class Choice: Day: Time:
Additional questions and comments:

By Selecting checkbox you Agree to each line to indicate your understanding and acceptance of the following policies:

 Agree MEMBERSHIP FEE: There is a $40 non-refundable annual membership fee per child, or $50 per family.
 Agree LATE PAYMENT FEE: Payment is due in full by the first day of class. There will be a $20 late applied after the first class of the payment period. To avoid a late fee you may enroll in Auto Pay (see below).
 Agree REFUND POLICY: No refunds are given for missed, dropped classes or instructor replacement.
 Agree Make Up Policy: Students are entitled to four (4) make-up classes within a semester. Make-up classes must be scheduled at least one week in advance. and does not carry over.
 Agree ENROLLMENT POLICY:Once your child is enrolled, their enrollment automatically carries over to semester 2 as long as full payment is submitted before the start of the session. If payment is not received your child's spot will not be held. If you are going to withdraw a form needs to filled out at least a month in advance..

Gymnastics Academy of Boston - Cambridge 2011-2012
Registration Form & Liability Waiver
128 Smith Place, Cambridge, MA 02138 (617) 441-9700

Child's Name:
Parent's Name:

BY CHECKING CHECKBOX BELOW, I acknowledge reading, understanding, and accepting the statements herein.

AGREEMENT TO PARTICIPATE AND LIABILITY WAIVER - I understand gymnastics and other sports activities involve risk and possible injury, including but not limited to paralysis, death, emotional distress, or damage to myself, to property, or to third parties.

I understand that it is my responsibility as a parent not to participate or allow participation if there are any physical, emotional, and behavioral or other problems that might compromise safe involvement. I understand that Gymnastic Academy of Cambridge, Inc. does not carry medical insurance for participants and forever release the corporation, staff, owners, facility, and equipment owners, and other related parties from the responsibility or liability for insurance deductibles, medical expenses, and/or other damages incurred by my child, myself, or other family members while participating or visiting the facilities, parking area, or traveling to or at a related activity. I expressly agree and promise to accept and assume all of the risks existing in this activity as outlined above.

My participation or my child’s participation in this activity is purely voluntary, no person(s) are forcing me or my child to participate and I elect of my own volition to participate or have my child participate with full knowledge of the inherent risks involved. I hereby voluntary release, forever discharge, and agree to hold harmless and indemnify Gymnastic Academy of Cambridge, Inc. from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of, or are in any way connected with my participation or my child’s participation in this activity, including those allegedly attributable to the negligent acts or omissions of Gymnastics Academy of Cambridge, Inc. or their staff.

Should Gymnastics Academy of Cambridge, Inc., or anyone acting on their behalf, be required for any reason to incur attorney fees and costs to enforce this agreement, I agree to indemnify and reimburse Gymnastics Academy of Cambridge, Inc. for such fees and costs.

I understand that injuries can and do occur and that health insurance is a requirement. I certify that I have health, accident, and liability insurance to cover any bodily injury or property damage I or my child may cause or suffer while participating in the sport of gymnastics or any other activities in or related to Gymnastics Academy of Cambridge, Inc., or else I agree to indemnify and reimburse Gymnastics Academy of Cambridge, Inc. for such fees and costs as incurred.

AUTHORIZATION OF MEDICAL CARE - In case of injury or illness during participation, I authorize and desire medical care for myself or my child at the discretion of the attending physician. I accept responsibility for all associated expenses.

PARENT RESPONSIBILITY TO SUPERVISE - When I visit Gymnastics Academy of Cambridge, Inc., or am involved in any related activity involving parental presence or participation, I understand and accept the responsibility, and any associated liability, of constantly supervising, controlling, and restricting activities as necessary to assure safety of the children I bring and myself.

PHOTOGRAPHS AND STATEMENTS - I authorize use of my own and my child's visual image and statements in newsletters, posters, and other advertising.

VALID DATES - These agreements, waivers, and authorizations will remain valid and in force as long as and whenever my child, myself, or any family member participates in any activity at or with Gymnastics Academy of Cambridge, Inc.

AGREEMENT TO PAY - I understand there are no refunds, credits, or guaranteed make-ups for missed classes due to personal reasons or inclement weather, and I am obligated to pay full tuition once a session begins. I accept the responsibility of paying for any damage to facility and equipment caused by myself or a family member.

By checking box below of this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found, by a court of law, to have waived my right to maintain a lawsuit against Gymnastics Academy of Cambridge, Inc. on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read and fully understand this entire document and I agree to be legally bound by its terms.

 Agree We have read and understand all the above and agree to the above terms, including the
Risk and Waiver of Liability.
Date:
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Date:

Testimonials

Click here to view a special video taken by a GAB Parent http://vimeo.com/17696795


Thank you GAB, for fulfilling a mother’s dream of seeing her child happy and looking forward each day to a camp of learning fun. My daughter has really developed and blossomed her social skills, she is certainly not the same shy child that first entered these doors. – A Newton Parent


I wanted to thank you all for a wonderful summer! My daughter had a great time and her confidence has improved almost as much as her agility – who knew our little one could bounce around like that! Thank you for your great work. – A Somerville Parent

Our Parties Are A Blast!!!

Our enthusiastic and experienced party staff will host and supervise your party where they will enjoy parachute games, the ever-favorite Tumble Trak, trampoline, obstacle courses and much more fun, fun, fun!!

Check out our Parties Section for more information !

 

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Join Us!-Register

Registration is OPEN! Classes are pro-rated!
Click here for 2016-17 Registration Form &Releases
Click here to print  a 2016 Spring Schedule  or  Register Online!

Need to Schedule a Make Up Class?
Pre-registration is required at least one week in advance

Call us at 617-441-9700 or email gabc.gymnastics@gmail.com

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