UMCA Open Gym Waiver
Filling out this form completely and signing is required for participation in UMCA Open Gym activities.   
Sign in to Google to save your progress. Learn more
Email Address *
Attendee's Name *
Attendee's Date of Birth *
MM
/
DD
/
YYYY
Parent or Legal Guardian Name *
Parent or Legal Guardian Phone Number
ASSUMPTION OF RISK * WAIVER OF LIABILITY* MEDICAL AUTHORIZATION* 

1.) SPORTS PARTICIPATION CAN BE DANGEROUS. I recognize that severe injuries, including paralysis or death can occur in any activities involving height or motion, those activities including but not limited to gymnastics, tumbling, trampoline, dance, and cheerleading. Being fully aware of these dangers, I hereby give consent for my child(ren) to participate in any and all programs and activities at Upper Moreland Cheerleading Association (and gym) and I ACCEPT ALL RISKS associated with such participation.

2.) In consideration for me or my child(ren)’s participation I hereby, for myself and my child(ren) our respective heirs and successors, PROMISE TO NOT SUE or FOREVER RELEASE Upper Moreland Cheerleading Association and its Entities and their respective officers, directors, shareholders, employees, contractors, and volunteers from all liability resulting from damages or injuries incurred as a result of participation including those resulting from the acts negligence.

3.) In the event of an accident or emergency, I hereby authorize my child(ren) to be transported to a hospital for medical treatment and I hold Upper Moreland Cheerleading Association and their representatives harmless in the execution of such. Additionally, I hereby agree to individually provide for all medical expenses which may be incurred by myself or my child(ren) because of any injury sustained while participating at or for Upper Moreland Cheerleading Association.

4.) I am aware that parents, grandparents, media, employees, or other persons my take videos on the Upper Moreland Cheerleading Association premises and in consideration for my or my child(ren) participation I hereby grant my permission for my or my child’s likeness to appear on the internet or in electronic or printed publicity or advertising.

I have read and understand this ASSUMPTION OF RISK and WAIVER OR LIABILITY and MEDICAL AUTHORIZATION and I VOLUNTARILY affix my name in agreement.


Electronic Signature
By printing your name below, you agree to the above.
*
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy