I, the undersigned, as parent or legal guardian of the child listed above in consideration of the request and permission of my son(s)/daughter(s) to participate in the activities involving height or motion, those activities including but not limited to gymnastics, tumbling, trampoline, yoga, aerials, dance, cheerleading, running, weight training, swimming, diving, exercise and fitness conducted by Kidtastics, LLC. I, the undersigned, as parent or legal guardian, hereby assume full responsibility for all the risks of injury or loss which may result from my son(s)/daughter(s) participation in these activity and hereby agree to hold harmless, release and forever discharge Kidtastics, LLC, it’s officers, agents, managers, supervisors, and employees from and waive any and all claims and demands whatsoever which the undersigned and any of them or any third person of any accident, illness, injury or death of any person and persons, or damage to or loss or destruction of any property arising or resulting from swimming, gymnastics, dance, weight training, and a variety of strenuous exercise, vigorous physical activities and/or running directly or indirectly from my son(s)/daughter(s) participation in the aforementioned programs and occurring during said participation or any time subsequent thereto, save and except that the above provisions shall not be applicable to injury to or death of persons, or damage to or loss of property arising out of the sole negligent acts or omissions of Kidtastics, LLC, their officers, agents, managers, supervisors, or employees. The terms of this release shall serve as release and assumption of risk for my own son(s)/daughter(s), heirs, executors and administrators and for all my family members. I understand, agree, and acknowledge that there are risks inherent in the sports activities conducted by Kidtastics, LLC, including, but not limited to paralyzing injuries, concussions, brain injuries and death. These activities may be of a hazardous nature and/or may include activities such as swimming, dance, gymnastics, a variety of strenuous exercise, and vigorous physical activities. With the full understanding of the facts, I state, that there are no apparent health conditions of my son(s)/daughter(s) listed on this application, which would hinder or prevent his/her active participation in the Kidtastics, LLC programs.
Consent for Emergency Medical Treatment:
In the event of a medical emergency, the undersigned Parent(s)/Guardian(s) of the above named child, hereby grants authorization to Kidtastics, LLC, and its representatives, to employ any legally licensed physician or health care facility on behalf of each of the undersigned, and to direct and/or order emergency medical treatment for the above named child. Each of the undersigned further agrees that neither Kidtastics nor any of its representatives shall be liable under any circumstances to anyone for exercising the foregoing authority in the event of an emergency. Further, I agree to pay all costs associated with medical care and transportation for the child. I have noted any and all medical or health problems the child has of which Kidtastics, LLC should be aware in the health considerations section of this form.
