Waiver

Participant's Name(Required)

First Last

Date of Birth(Required)

Participant's Age(Required)

What grade is your child in?(Required)

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Parent/Guardian Phone(Required)

Parent/Guardian Name

First Last

Parent/Guardian Email

Parent/Guardian Phone

Were you referred to the gym?(Required)

Yes

If so, by whom?(Required)

Waiver Policy and Consent(Required)

I understand and agree.

Acknowledgment of Risks:

I, as the parent and/or legal guardian, recognize that severe injuries, including permanent paralysis or death, can occur in sports or activities involving height or motion; those activities include but are not limited to gymnastics cheerleading, tumbling, trampoline, movement education, dance, ninja, and stunting. I also realize that my child will be performing and training on gymnastics events plus various other training devices, including trampolines. I certify that I have consulted a physician, to the extent that I deem appropriate, concerning my child's participation in these activities. I represent to Quantum Athletics LLC that my child is medically fit to participate. I also am aware that participation in day camps and competitions involved transportation to and from field trips and competitions and that such transportation could result in injury or death in a vehicular accident. Furthermore, I recognize that because of increased movement, height, flipping, twisting, and inversion, the competitive pursuit of these sports and activities carries a higher degree of risk of catastrophic injury than do the recreational versions.

Photo Release:
I am aware that individual and group publicity photos and videos are taken from time to time and in consideration for my child's participation I hereby grant permission for my child's likeness to be used in Quantum Athletics LLC publicity or advertisement.

Consent to Medical Treatment:
In the event of an accident or emergency, I hereby authorize Quantum Athletics LLC and its representatives, including its employees, contractors, teachers, coaches, and volunteers to render first aid to my child to the extent they deem appropriate. I further authorize Quantum Athletics LLC and its representatives to transport or arrange medical transportation by ambulance, if Quantum Athletics LLC deems it appropriate, for my child to a hospital or any other medical or dental facility for medical or dental treatment I authorize Quantum Athletics LLC and its representatives, to consent to medical and dental treatment for my child. I agree to hold Quantum Athletics LLC and its representatives harmless from any and all decisions made with respect to medical and dental treatment for my child. Additionally, I hereby agree to be personally responsible for payment of all medical and dental expenses, including transportation, which may be incurred by myself or on behalf of my child as a result of any injury sustained while participating at or for Quantum Athletics LLC, including future medical and dental expenses related to such injury.

Being fully aware of these dangers, I hereby give consent for my child to participate in any and all Quantum Athletics LLC programs and activities for which they are registered and I ACCEPT ALL RISKS associated with this participation.

Waiver & Release:
In consideration for my or my child's participation, I hereby, for myself and my child and our respective heirs and successions, PROMISE NOT TO SUE and FOREVER RELEASE AND DISCHARGE Quantum Athletics LLC, its officers, directors, shareholders, employees, contractors, teachers, coaches, volunteers from all liability resulting from damages or injuries incurred as a result of participation in Quantum Athletics LLC programs, including those resulting from acts of negligence. I understand that Quantum Athletics LLC has relied upon this agreement in determining the extent of insurance coverage be obtained and that in absence of this release, Quantum Athletics LLC would charge considerably higher fees to participants.

Parent/Guardian Signature(Required)

I have read and understand Quantum Athletics' wavier for participation and tuition information. My signature indicates my voluntary agreement with the terms set forth above.