CENTRAL PENNSYLVANIA ACADEMY OF GYMNASTICS
RELEASE FORM
IN CONSIDERATION of allowing the named student to enroll in a gymnastics school and program and the use by the student of the premises and property of
said school, the undersigned, being the legal and acting guardian of the student, acting for themselves and on behalf of the student, release and hold
harmless the CENTRAL PENNSYLVANIA ACADEMY OF GYMNASTICS, INC., a Pennsylvania corporation, its owners, employees, and agents of and from any
and all liability, claims, demands, actions and causes of action whatsoever, arising out of or related to any loss, damage or injury, including death, that may
be sustained by the student and / or the undersigned, while in, on, or upon the premised upon which the school is conducted, or any premises under the
control and supervision of CENTRAL PENNSYLVANIA ACADEMY OF GYMNASTICS, INC., its owners, officers, employees and agents, or en route to or from
any said premises, or while at any other premises or place when undertaking activities whatever kind or nature related to activities sponsored by or
participated in by CENTRAL PENNSYLVANIA ACADEMY OF GYMNASTICS, INC., a Pennsylvania corporation, its owners, employees, and agents.
ASSUMPTION OF RISK
Participating in gymnastics involves motion, rotation and height in a unique environment and as such carries with it a certain assumption of risk. The un-
dersigned and the student elect voluntarily to enter upon said premises under the control of said corporation, knowing their present condition and knowing
that said condition may become more hazardous and dangerous during the time that the student or the undersigned is upon said premises. The under-
signed and student voluntarily assume all risks and loss, damage or injury that may be sustained by the student and or the undersigned or and property
owned increase the liability of the corporation to the student and or the undersigned or effect the terms of this release.
In signing this release, the undersigned acknowledges;
A. That he or she has read the release, and signs voluntarily.
B. That the undersigned signing as legal guardian are in fact the true legal guardians and has the consent of the student.
X Signature of Parent / Guardian _________________________________________________________________________Date: _____/_____/______
PARENT / GUARDIAN WAIVER FORM
I agree that my son / daughter named on reverse attending Central Pennsylvania Academy of Gymnastics, Inc., will be engaging in gymnastics exercise involving various sports,
coordination events, and fitness training which could cause injury to them. I agree that my son / daughter is participating in these activities and I am assuming all risks of injury that
might result. I hereby agree to waive any claims or rights that I might otherwise have to sue Central Pennsylvania Academy of Gymnastics, Inc., its employees, owners, officers, or
agents for injuries that might occur as a result of these activities. Central Pennsylvania Academy of Gymnastics, Inc., will make no evaluation or recommendation as to whether your
son / daughter is physically fit for any exercise activity. It is always advisable to consult a physician prior to undertaking any physical exercise program. If my son / daughter has any
physical condition that may impair their ability to engage in these activities, it is my responsibility to obtain a physician's statement describing any limitations to participate in the
program.
X Signature of Parent / Guardian _________________________________________________________________________Date: _____/_____/_____
Publicity Release Form for Photographs & Videotaping
Many exciting events are captured on film. CPAG will be taking pictures of students to display on our bulletin b oards, newsletter and our web page. Please
fill out this release form as to your preference in displaying your child's picture and return it to CPAG as soon as possible. No children's names or ages will be
used. I do _____ ( or ) I do not _____ give permission for my child's picture to be used for advertising or display on Central PA Academy of Gymnastics
bulletin boards, newsletter, and web page.
CPAG POLICY STATEMENT
PAYMENT
* Payment and completed registration / Waiver form are due at time of enrollment.
* Payment can be made by check or cash.
* Make checks payable to CPAG, with phone number and child's name, class, day, & time written in memo area.
* Returned check fee is $30.00.
* Cash payment should be placed in an envelope with child's name and class noted.
* All payments should be given to a CPAG staff member at the front desk. If staff is unavailable, place in payment box by office.
REFUNDS
* There are NO refunds after the 3rd week of class, except for medical reasons.
* Membership fee is non-refundable.
MISSED CLASSES
* Make-up classes are available. ONLY 2 MAKE-UP CLASSES EACH SESSION. There are NO deductions for missed classes.
ARRIVAL & DISMISSAL
* Students arriving more than 10 min. late will not be permitted in class. Please schedule a make-up.
* Children are not permitted outside the building without an adult.
ATTIRE
* Girls- One piece leotard, no skirt. Hair in a ponytail, bare feet.
* Boys- Athletic pants, long or short, t-shirt tucked into pants, bare feet, no oversize clothing.
* NO JEWELRY OF ANY KIND.
SAFETY
* Proper behavior is very important for the safety of your child. Any student acting in an inappropriate manner will be asked to leave the gym. Continued
misconduct will be cause for permanent dismissal from the program--NO REFUNDS WILL BE GIVEN.
* Children need to wait quietly in the designated waiting area. Parents are responsible for their child's behavior and safety in these area. No gymnastics,
ball playing, heelys or running in waiting areas.
X Signature of Parent / Guardian ________________________________________________________Date: _____/_____/_____
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