GYM LOCATION WAIVER AND RELEASE OF LIABILITY

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GYM LOCATION WAIVER AND RELEASE OF LIABILITY

ALL PARENTS ARE REQUIRED TO SUBMIT THE WAIVER FORM BEFORE THE SCHEDULED CLASS

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* Indicates required question

Email *

Your email

Parent/Guardian Name *

Your answer

Parent/Guardian Birth Date *

MM

/

DD

/

YYYY

Parent/Guardian Age *

Your answer

Phone Number *

Your answer

Complete Address *

Your answer

Participant/Child Name *

Your answer

Child's Date of Birth *

MM

/

DD

/

YYYY

Gender *

Male

Female

PLEASE SELECT YOUR REGISTERED ATTENDANCE GYM LOCATION.

NOTE: SINAI TEMPLE PARTICIPANTS NO WAIVER NEEDED

*

EMEK HEBREW ACADEMY

DE TOLEDO HIGH SCHOOL

WESTSIDE JCC

VALLEY BETH SHALOM

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