Student Name *
Student Name
Student Date of Birth *
Student Date of Birth
Student age at time of class.
Guardian Name *
Guardian Name
Phone *
Class Choice *
Please note that we are closed for Late Summer Break from August 26 - September 8. We are happy to schedule your trial class before we close or fter we resume 9/9.
Date *
Please enter date of requested trial class.
Waiver & Release *
Release of Liability: The Renaissance Gymnastics Academy, Inc., its coaches, other staff members, and the corporate officers both paid and volunteer will not accept responsibility for injury sustained by any student during the course of gymnastics and dance instruction, or open work out, or in the course of any exhibition, competition or clinic in which he or she may participate or while traveling to of from the event. With the above in mind, and being fully aware of the risks involved, I consent to have my child(ren) participate in the programs offered by Renaissance Gymnastics Academy, Inc. I, my executors, or other representatives, waive and release all rights and claims for damages that I or my child(ren) have against Renaissance Gymnastics Academy, Inc. and/or its representatives, paid or volunteer. I also affirm that I now have and will continue to provide proper hospitalizations, health and accident insurance coverage which I consider adequate for my child's and my own protection, I also understand that it is the parents’ responsibility to warn the child of the dangers of gymnastics and dance and injury. The parent should warn the child according to what the parent feels appropriate. Renaissance Gymnastics Academy, Inc. will only warn the child through “safety messages” and our teaching styles and progressions. Assumption of Risk: We the staff of Renaissance Gymnastics Academy, Inc recognize our obligation to make our students and their parents aware of the risks and hazards associated with the sport of gymnastics and dance. Students may suffer injuries, possibly minor, serious, or catastrophic in nature. Gymnastics and Dance can be dangerous and can lead to injury. Parents should make their children aware of the possibility of injury and encourage their children to follow ALL the safety rules and coaches' instruction. Medical Emergency: I fully understand that the Renaissance Gymnastics Academy, Inc. staff members are not physicians or medical practitioners of any kind. With that in mind I hereby release the Renaissance Gymnastics Academy, Inc. staff to render temporary first aid to my child or children in the event of injury or illness, and if deemed necessary by the Renaissance Gymnastics Academy, Inc. staff, to call their doctor and seek medical help, and if deemed necessary for the calling of ambulance for said child(ren).