Northeast Institute of Gymnastics

Birthday Party Release Form

I recognize that Gymnastics, tumbling, and any activity which involves inversion of the body, motion, height, and or rotation may cause accidental injury, including, but not limited to, muscle or other soft tissue strains, sprains and tears, broken bones and severe injuries including permanent paralysis or even death. I am fully aware of the inherent risks involved in gymnastics and other activities at Northeast Gymnastics. With this understanding I hereby give consent for my child(ren) to participate in gymnastics at Northeast Institute of Gymnastics.

I the minor's parent and /or guardian, understand the nature of the above referenced activities and the minor's experience and capabilities and believe the minor to be qualified to participate in such activity offered by Northeast Institute of Gymnastics. I, my heirs and assigns, next of kin, and all others acting on my behalf agree to waive any and all rights, claims, damages, actions, causes of action or suits of any kind or nature whatsoever which I have or my child has against Northeast Institute of Gymnastics or any agent, employee, representative or other acting on their behalf and to indemnify, defend and hold harmless Northeast Institute of Gymnastics or any agent, employee, representative or other acting on their behalf for any injuries suffered as a result of engaging in those activities offered by Northeast Institute of Gymnastics . It is also my intent to release discharge, covenant not to sue Northeast Institute of Gymnastics it's respective administrators, directors, agents, officer, volunteers and employees and if applicable, owners and lessors of premises on which the activity takes place from liability for ordinary or gross negligent conduct that may occur in the future and agree not to sue. Should any part or parts of this agreement be held null and void, the gross balance of the gross agreement shall remain valid and maintain its full force and effect. This acknowledgment of risk and release of liability has been read by me and understood completely and signed voluntarily. I am 18 years of age or older.

By agreeing to this I understand that even though I am not taking gymnastics and will not be on the equipment I may injure myself being in the gym, or outside the building in the parking lot. I take full responsibility for my actions and agree to pay for any and all medical, bills that might arise from an accident at Northeast Institute of Gymnastics. This could include, but not limited to stepping off uneven mats and twisting an ankle, broken bones, torn ligaments, spine injuries or even death.

I hereby release Northeast Institute of Gymnastics to render first aid to my child in the event of any injury or illness, fully understanding that they are not physicians or medical practitioners of any kind. If deemed necessary, and if the parent or guardian, are not available I hereby authorize a representative of Northeast Institute of Gymnastics to call an ambulance that I agree to pay for. As a parent or legal guardian, I agree to provide health insurance for the minor child and/or guarantee payment of any medical expenses incurred as a result of training, performing, or participation in activities with Northeast Institute of Gymnastics.

PARENT/LEGAL GUARDIAN'S SIGNATURE______________________________________________DATE____________________________

Participant' Name___________________________________________________________________________________________________________