Gymnastics Waiver Form
Please fill out this waiver form before participating in gymnastics activities.
Participant's Full Name
First Name
Last Name
Participant's Date of Birth
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian's Full Name
First Name
Last Name
Parent/Guardian's Email Address
example@example.com
Parent/Guardian's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Relationship
Please provide any relevant medical information or allergies that we should be aware of.
Do you have any pre-existing medical conditions that may affect your ability to participate in gymnastics activities?
Yes
No
If yes, please provide details
In case of an emergency, I give my permission for the necessary medical treatment to be administered to the participant.
*
I agree
Submit
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