Gymnastics & Cheerleading Academy
2011-2012 Registration

STUDENT INFORMATION

First Name ______________________  Last Name _________________________ D.O.B.  ____/____/____    Age _______

Phone (       )_______________________             Address____________________________________________________ 

City ___________________________________  State____________   Zip___________________

Medical facts we should be aware of:__________________________________________________________

PARENT-GUARDIAN INFORMATION

First Name _______ _________ Last Name __________________________ Home Phone: (        )____________________ 

Cell Phone  (        )_______________________________                  Work Phone:  (        ) ___________________________

E-mail: ______________________________________________________________________________

EMERGENCY CONTACT INFORMATION

Name:_____________________________________  Relationship to student:__________________________

Home Phone: (        )_________________________      Cell Phone:  (        ) ___________________________

SIGNATURE REQUIRED TO COMPLETE REGISTRATION ~ By signing below, you fully understand and comply with all Absolute’s Rules & Policies

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. Calls will be made for Absolute announcements including but not limited to: weather cancellations; make-up classes; enrollment payment deadline dates, show info (days/times, payment info for show outfits, tickets, etc.)

Signature of Parent or Guardian: ____________________________________________Date:_____________

Class Enrollment Information

1^st Choice:
Class Name: ___________________________   Day: ____________ Time:  _________  Age Group: _____________

2^nd  Choice:
Class Name: ________________________________   Day: ____________  Time:  _________  Age Group: _____________

*Assume your first choice has been accepted unless notified otherwise
*Absolute reserves the right to change/cancel class schedules as demed necessary

FOR OFFICE USE ONLY

Amt Pd: ____________     Check #:___________     Date Rec’vd: ___________     Reg Fee: ________     Tuition: ___________

Class Entered: ________________________ / Day _________ / Time _________ / Instructor ___________________________

Absolute ~ 87 Progress Ave ~ Tyngsboro Ma 01879 ~ absolutegymnastics.com ~978 649-7722