ATO, Inc. P.O.W.E.R Sessions Registration Form 2021-2022
Student Name *
Student DOB: *
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Grade: *
Student Email: (type n/a if none) *
Student Cell: (type n/a if none) *
Student Allergies/Medications/Medical Concerns: (type n/a if none) *
Parent/Guardian Name: *
Parent/Guardian Primary Contact: *
Emergency Contact Name and Number: (if parent/guardian can't be reached): *
New or Returning Student: *
Class of Interest:  (Check all that apply) *
Required
Today's Date: *
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By checking "I agree" below and submitting this form, you the parent/guardian of the above student agree to release "ATO, Inc." including coaches and assistants from liability for any and all injuries which may occur while training, practicing, performing, or during any studio event or activity.  You also agree that you are responsible for health and accident insurance and any medical costs incurred due to injury.  You give permission for emergency medical transportation and treatment of your student at your expense should the need arise.  You also give your permission for the public display of any studio visual images that your student may appear in. *
Academy Policies and Information:  I have read all studio information and policies including monthly fees, insurance, bad weather/holiday policies, attendance, class observation, behavior, and practice wear.  I fully understand and agree to abide by these policies. *
ATO, Inc.
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