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Summer Camp Registration Form  ~ Printed from Website  2007

Child’s Name__________________________________________ Home Phone_______________
Address_____________________________________________City_______________State_____
Zip Code______________  Date of Birth________________  Age_______ Cell #__________________
Parent’s Name (s)_____________________________________________
Email Address _________________________________
REGISTRATION FEE
There is a $10 Registration Fee for a non-Spirit member for camp at SPIRIT Gymnastics Training Center. 
 This fee is good for all Summer Camps in 2007, along with the appropriate camp payment,
assures enrollment in a specified camp.  Most of the fee is utilized for insurance which is required by USA Gymnastics for participation in “Member Club” gymnastics activities or programs.  See below for the benefits of this policy.
This registration fee is non-refundable.
SPIRIT Gymnastics Training Center is a division of Family Fun Gymnastics Center inc.  All references are to both organizations.

Please list any physical handicaps, allergies, drug reactions, or ailments that we should know about during class or in case of medical emergency.
IF NONE, PLEASE INITIAL HERE ________

_________________________________________________________________

Please list any sight or hearing problems, learning disabilities, or other characteristics so that we may better prepare for your child’s needs.
IF NONE, PLEASE INITIAL HERE ________

By the very nature of the activity, gymnastics carries a risk of physical injury. No matter how careful the gymnast and the coach are,
no matter what height is used or what landing surface exists, the risk cannot be eliminated – reduced yes, but never eliminated.
The risk of injury includes minor injuries such as bruises and more serious injuries such as broken bones, dislocations, and muscle or fiber
 pulls or tears. The risk also includes catastrophic injuries such as permanent paralysis or even death from landings or falls on the back,
neck or head. Your signature on this form indicates that you understand this risk.
In the event that you cannot be reached during an emergency, please provide us with the name of a friend or relative who can be
contacted in your absence.
Name___________________________________ Phone_________________Relationship_________________

ENROLLMENT INFORMATION

Camp_______________________________  Dates__________________  Time___________
We agree to abide by the rules and regulations of the SPIRIT Gymnastics Training Center.  We hereby, for ourselves and our child,
adopted or otherwise, our heirs and executors, waive and release any and all rights against SPIRIT Gymnastics Training Center,
their coaches, agents and representatives, for any injury or damages that may be suffered by us, our child, adopted or otherwise,
in connection with our and his or her association or entry in gymnastics, or other activities performed or sponsored by SPIRIT
Gymnastics Training Center or the Spirit Teams.  We also understand that the insurance provided by the Registration Fee is
“secondary insurance” which supplements our primary personal or group medical insurance.  If we do not have medical insurance,
we understand that we are subject to a $500 deductible, and the limits of the policy for each injury, and that SPIRIT Gymnastics
Training Center, their coaches, agents and representatives will not be responsible for medical expenses incurred as a result of any injury. 
I/WE certify that: 1.  There are no physical problems not identified above which would endanger my child’s safety or well being
when involved in any form of activity run or sponsored by SPIRIT Gymnastics Training Center or the SPIRIT Gymnastics Team;  2. 
I am the legal parent/ guardian of this child.  AND 3.  I have read the guidelines on the opposite side; and I agree to follow the published guidelines. 
 I/WE hereby give permission for SPIRIT or its representatives to obtain emergency medical assistance for this child in my absence.
WEBSITE & ADVERTISEMENT RELEASE
SPIRIT publishes a website to inform members and the public about the Center and its activities. 
Please initial the appropriate statement concerning your child and sign below.
_________ I authorize SPIRIT and their agents to publish my child’s class or team photo(s) on the Spirit Website or in ads.

_________ I do not give permission to publish my child’s class or team photo(s) on the Spirit Website or in ads.
                                                                **  www.spiritgymnastics.com **