Gymnastics Michiana Activity Waiver
ASSUMPTION OF RISK, WAIVER OF LIABILITY, MEDICAL AUTHORIZATION, and PHOTO/VIDEO RELEASE
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As legal guardian of *
hereafter, participant(s), I understand the nature of this activity and that I and/or my children are qualified, in good health and in proper physical condition to participate in such activity. I acknowledge that if I believe event conditions are unsafe or I/they are unable to safely perform any activity, I will immediately discontinue participation in the activity. I fully acknowledge, understand, appreciate and agree, that this activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the Releasees named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the activity. I further acknowledge, understand, appreciate and agree that my participation may result in possible exposure to and illness from infectious diseases, including, but not limited to, MRSA, Influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation and exposure. Being fully aware of these dangers, I voluntarily consent to the aforementioned person(s) participating in any and all Gymnastics Michiana’s programs and activities and I ACCEPT ALL RISKS associated with that participation. In consideration for allowing me and my child(ren) to use these facilities, I, on behalf of my child(ren) and our respective heirs, administrators, executors and successors, hereby CONVENANT NOT TO SUE and FOREVER RELEASE Gymnastics Michiana, its officers, directors, shareholders, employees or agents from all liability for any and all damages or injuries suffered by my child(ren) while under the instruction, supervision, or control of Gymnastics Michiana, including without limitation, those damages or injuries resulting from acts of negligence on the part of its officers, directors, shareholders, employees, or agents. In the event of an emergency I would like my above mentioned child(ren) to be taken to a hospital for medical treatment and I hold Gymnastics Michiana and its representatives harmless in their execution of this action. Additionally, I hereby agree to individually provide for all possible future medical expenses which may be incurred by me or my child as a result of any injury sustained while participating at Gymnastics Michiana. By participating in activities here at Gymnastics Michiana, you are granting your permission for you and your child(ren) to be filmed, videotaped, audio taped, and/or photographed by any means and are granting full use of your likeness, voice, and words without compensation. Do you understand this ASSUMPTION OF RISK, WAIVER OF LIABILITY and MEDICAL AUTHORIZATION and VOLUNTARILY affix your name in agreement? *
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