GYMSTRADA BIRTHDAY PARTY WAVIER FORM

(PLEASE PRINT)

Date:____________

Student's Name:_______________________________________Birthdate:________________
                             (Last)                                (First)
Address:_____________________________________________
City:__________________________State:_____Zip:__________
Phone: (____) ______--_________

Parents' Names:__________________________________________
                                     (Mother)                                              (Father)
Cell Phone:  (____) ______--_________    (____) ______--_________
                                     (Mother)                                            (Father)

RELEASE STATEMENT
Participation in gymnastics activities involves motion, rotation and height in a unique environment.  As such, it carries with it a reasonable assumption of risk.  As with any sport activity, in juries can result from improper conduct of that activity.  Although most injuries that occur in gymnastics are minor in nature, the potential for the rare catastrophic injury does exist.  Therefore, it is important for every student enrolled in Gymstrada's program and their parents to appreciate the risk involved.

I have read the Release Statement and understand that, as with any sport activity, there is a reasonable assumption of risk when participating in gymnastics activity.  I give my permission for my child, _______________________, to participate in the program offered by Gymstrada Schools, Inc.  

There can be no adult participating on equipment for birthday parties.  Only children 18 years old and under may partake in the equipment activities during birthday parties (this includes the trampoline).

__________________________________________________                            ___________________
(Signature of Parent or Guardian)                                                                                         Date