• Participation: I consent to have my child or children participate in the programs offered by Canyon Creek Gymnastics & Tumbling. I, my executors, or other representatives, forever waive and release all rights and claims for damages that I or my child may have against Canyon Creek Gymnastics & Tumbling and / or its representatives whether paid or volunteer. I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage, which I consider adequate for both my child’s protection and my own protection.

• Medical Attention: I fully understand that Canyon Creek Gymnastics & Tumbling staff members are not physicians or medical practitioners of any kind. With the above in mind, I hereby release the Canyon Creek Gymnastics & Tumbling staff to render first aid to my child or children in the event of any injury or illness, and if deemed necessary by the Canyon Creek Gymnastics & Tumbling staff to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation by a Canyon Creek Gymnastics & Tumbling staff member or its representatives, whether paid or volunteer, or the calling of an ambulance for said child should the Canyon Creek Gymnastics & Tumbling staff deem this necessary.

• Waiver: I am aware that I should make my child or children aware of the possibility of injury and will encourage my children to follow all the safety rules and the coaches’ instructions. I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, and even death, as well as other damages and losses associated with participation in gymnastics activities and events. I further understand that it is the parents’ responsibility to warn their children about the dangers of gymnastics and injury. Canyon Creek Gymnastics & Tumbling, its coaches and other staff members, will not accept responsibility for injuries sustained by any student during the course of gymnastics, trampoline, tumbling, cheerleading, or dance instruction, or open workouts or in the case of any exhibition, competition, or clinic in which my children may participate while traveling to or from the event. I also agree that Canyon Creek Gymnastics & Tumbling, its coaches and other staff members, shall not be liable for any losses or damages occurring as a result of my children’s participation in the event. Canyon Creek Gymnastics & Tumbling will only warn the child through "Safety Messages" and our teaching style and progressions.

I do hereby verify that I have read and understand and accept each of the above policies and conditions shown by checking the box YES below and that I am the legal adult of the student below.

* Required fields
Name *
E-mail Address *
By checking yes, I have agreed to and read the above medical release form. *	YES NO
1st Child's Name *
Program *
Gender *
Age *
D.O.B. *
Medical conditions, if any
2nd Child's Name
Program
Gender
Age
D.O.B.
Medical conditions, if any
3rd Child's Name
Program
Gender
Age
D.O.B.
Medical conditions, if any
Mothers Name *
Home Phone Number *
Occupation
Work number
Cell Number
Fathers Name *
Home Phone Number *
Occupation
Work number
Cell Number
Address *
City *
State *
Zip
Emergency Contact Person *
Phone Number *
Family Doctor
How did you hear about us?
Friends Name
Comments
ONLY USE BELOW IF REGISTERING FOR CLASS PROGRAM
	If your child is registering for our class program, please check box and continue to remaining portion of form.
I have read and agree to the rules and policies stated below	YES NO
1. Tuition is due on the 1st of each month. If tuition is not received by the 10th of the month, a late fee of $10.00 will be applied to your account. An additional late fee of $10.00 will be applied to your account if tuition is not received by the 20th of each month. Child(ren) will be dropped from the program if tuition is not received by the end of the month; you will still be responsible for the tuition past due.	YES NO
2. An annual registration fee of $30.00 must be paid before any class assignments can be made. The registration fee for the 2nd child is $20.00 and for the 3rd is $10.00. Registration for a family is $60.00. This is a non-refundable fee and is not part of your monthly tuition. This fee is renewable each year.	YES NO
3. Students are allowed one make-up class per month. Make-ups must be done within two weeks of the missed class. CCGT will not refund, discount or prorate for missed classes. Make-ups must be scheduled through the office in advance; availability is not guaranteed.	YES NO
4. Lessons are based on an average of 4 classes per month per calendar year. Accounts will not be charged for months with 5 classes nor will they be credited for months with 3 classes. Holidays and closings are included in the average. Notices will be handed out for closings.	YES NO
5. Cancellations due to weather or circumstances beyond the control of CCGT do not constitute a make-up day. CCGT reserves the right to cancel any class at anytime. You will be contacted to arrange another class time.	YES NO
6. CCGT’s tuition runs month to month, and its program runs throughout the year; this means through the summer as well. If there will be a period of time in wish you will not be paying tuition, the office must be given a minimum of 2 weeks written notice prior to ceasing payment. Telling a staff member or phone calls are not permitted. You will be responsible for paying tuition for the month if written notice is not received.	YES NO
OFFICE STAFF USE ONLY BELOW
1st child trial Date/Class/Time
2nd child trial Date/Class/Time
3rd child trial Date/Class/Time
Registration Fee
Date
Payment Form
Start Date
1st Month's tuition amount
Tuition Amount Monthly