ABSOLUTE GYMNASTICS ~ SUMMER 2011
                                                 July 11th - August 22nd

STUDENT INFORMATION

First Name _______________________________ Last Name __________________________________

Birthday _______/_______/______ Age _______ Phone # _______________________________

Address______________________________City _______________________State_____ Zip________

Medical facts we should be aware of: ______________________________________________________

First Name ______________________________________ Last Name _____________________________

Home Phone (       )________________________    Work Phone (       ) ____________________________

Cell Phone ( )_______________________ E-mail: _______________________________________

Emergency/Alternate Contact Name/Phone _________________________________________

ACKNOWLEGEMENT OF RISK & RELEASE OF LIABILITY - As legal guardian of ____________________________________, age _______, I hereby release Absolute Gymnastics Academy, Inc., its owners, officers, employees, teachers and coaches from liability for any and all damages and injuries to my child while under instruction, supervision or control of Absolute Gymnastics Academy . As legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses, which may be incurred by my child as a result of any injury sustained while training at or performing at/for Absolute Gymnastics Academy . By voluntarily signing this release, I acknowledge my understanding of the above and hereby give my permission to trained medical professionals to administer emergency medical treatment to my child should sickness or accident occur in my absence.

PHOTO OPPORTUNITIES During the course of the year, there are many photo opportunities your child may be exposed to. These opportunities may occur at Absolute, during any away meet or competitions, parades, exhibitions, parties, sleepovers, etc. Photos may be used for newspapers, our website, posted in the gym, etc. If you do not want your child’s picture used in any public forum – please indicate by submitting written notice stating such ~ include name, class day, class time and signature.

CALL LISTS: Upon registering you will be added to our call list. Call will be made for Absolute announcement including but not limited to: weather cancellations, make-up classes, enrollment payment deadline dates, show info (days/times, payment for show outfits/tickets, etc.)

By Signing Below you fully understand and comply with above:

Signature of Parent or Guardian _________________________________________ Date: _________

SUMMER CLASS REGISTRATION ~ 7-WEEK SESSION ~ Full payment and registration must be received by JUNE 15th

Class:__________________               Age: _______                    Day/ Time: _____________ 

                                                    Circle  Kid’s Club Weeks below

Kid’s Club Weeks:        1                    2                  3                  4                5

                                   (7/12-7/14)             (7/19-7/21)          (7/26-7/28)          (8/9-8/11)        (8/16-8/18)

             1 hr Class:  $125 /summer                      Kid's Club:  $75/wk

               Summer Tuition:  ________ + Registration Fee: ** $12.50 = $__________

** Registration Fee: Waived for current 10-11 Absolute Members

                                                                      FOR OFFICE USE ONLY

                      Amt Pd: _______________ Check #: ______________ Date Received:____________________

                      Reg Fee: _________ Tuition: ____________ Class Entered: _____________________________

87 PROGRESS AVE ~ TYNGSBORO MA 01879
978 649-7722