Open Gym is a great time
for gymnastic enthusiasts to get extra help on and try new skills, spend
time on your favorite event and meet new friends! While this is not a structured class, PGTC staff will be on
hand to help you with what you would like to work on regardless if it’s a
standing bridge, back handspring on floor or beam or a flipping vault. Non-PGTC students are welcome to attend,
however, a release form must be filled out by the participants parent or
legal guardian before taking part in any PGTC activity. Release form must be presented on the
day of Open Gym.
If you are a current PGTC student, you
DO NOT need to fill out release form.
If you have any questions, feel free to
contact us at 628-4966.
|
|
Pottsville Gymnastic Training Center
OPEN GYM
Fees: $7.00 Current PGTC Member; $10.00 Non-Member (All fees non-refundable)
Name:
__________________________________________ Age: ___ School:
______________ Grade: ____
Address:
________________________________________
Phone: __________ Email:
__________________
City:
__________________ State:
_____ Zip Code: ____ Currently Taking Classes? Where?
__________
WAIVER AND RELEASE OF LIABILITY
I am fully aware of and appreciate the risks, including the
risk of catastrophic injury, paralysis, and even death, as well as other
damages and losses associated with participation
in sports including
gymnastics and cheerleading.. The risk of harm in gymnastics may be limited
by all of the safety equipment and trained coaches, but never
eliminated.I agree to accept those risks and voluntarily participate. In
consideration of my participation,
I hereby for myself, my child(ren), adopted or otherwise, my heirs
and executors, release and covenant not-to-sue the
POTTSVILLE GYMNASTIC TRAINING
CENTER, or any of their employees, teachers, coaches, agents, sponsors,
volunteers or representatives,from any and all present and future claims
resulting from ordinary negligence on the part of Pottsville Gymnastic
Training Center or others listed for property damage, personal injuryor
wrongful death, arising as a result of my engaging in or receiving
instruction in gymnastics or any other activities or any activities
incidental thereto, wherever, whenever or however the same may occur. I hereby voluntarily waive all claims,
both present and future, that may be made by me, my family, estate, heirs
or assigns.
I further agree to idemnify and hold harmless the Pottsville
Gymnastic Training Center and all listed for any and all claims arising as
a result of my engaging in or receiving instruction
in Pottsville Gymnastic
Training Center activities or any activities incidental, thereto, whenever,
wherever or however the same occur.
As a legal
parent or guardian of this participant, I hereby verify by signature below
that I fully understand and accept each of the above conditions for
permitting my child to participate in
gymnastics and other
activities sponsored by the Pottsville Gymnastic Training Center. If any part or parts of this agreement
are held void, this will have no effect upon the validity of the remainder
of the document.
I have read this form fully and understand the
waiver and release of liability as well as the rules and policies of the
Pottsville Gymnastic Training Center.
__________________________________________________________________________________________
_______________________________________
(Signature
of parent/guardian) (And participant IF over 18) (Date
signed)
Pottsville GTC P.O. Box
631 Pottsville, PA 17901 For Further Information: info@pottsvillegymnastics.com (570) 628-4966
|
|
