Fire and Ice Trial Release Form
Please email info@fireandiceallstars.com for more information!
Child's Name *
Parent's Name *
Address *
Phone number *
Parent Email Address *
Child's Age *
Medical Release: I hereby give permission for my son/daughter to participate in Fire and Ice Allstars TUMBLING and/or Fire and Ice Allstar programs. I understand that none of the entities involved (the Inc, or gym) carry medical, or accident insurance for students participating in any of our programs. I further understand fundraising monies may not be used to pay for medical treatments due to any personal injuries sustained while practicing, competing or otherwise participating in TUMBLING or Fire and Ice Allstar programs. It is understood that I will, and do, assume full responsibility for medical treatment that may be needed or required.I hereby certify that my child is covered by a personal insurance policy which I have in effect and will keep in effect for the duration of my child's participating in the program. I will notify the Owners, in writing, if any changes are made to the insurance information I have supplied. *
Required
Liability Release: I authorize Fire and Ice Allstars Inc. and its representatives to consent to medical treatment for my child when I cannot be reached to so consent. I also give Fire and Ice Allstars, Inc. permission to administer the necessary emergency care to my child to stabilize and/or improve the current injury or condition that my child may have sustained during activities related to Fire and Ice Allstars, Inc. instruction, practices, or performances. No prior determination to life threatening emergency or danger of serious permanent injury resulting from treatment need be made under this authorization. Exceptions to this authorization are as follows:I am fully aware that any activity involving motion, height, or athletic activity creates the possibility of serious injury, and I further agree to hold Fire and Ice Allstars, Inc. and its staff and officers harmless for any injury resulting expense(s). I release and discharge all rights and claims against Fire and Ice Allstars, Inc. Fire and Ice Allstars, Inc. strives to provide the maximum in safety procedures and guidelines, and therefore assume no responsibility for any accidents or injuries that may occur. Finally, I authorize Fire and Ice Allstars, Inc to use my child's name and/or picture in any media/press release, and gym related promotions, including but not limited to, Fire and Ice Allstars website, promotional material, and other such items. *
Required
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