Open Gym/Clinic Date (waiver must be completed before each attendance) *
MM
/
DD
/
YYYY
Please note what organization/gym you are with (note that open gym is only open to current AJS Pancott members or pre-approved individuals) *
Your answer
By initialling below, I confirm that I am the parent of the child I am signing up and have read the Open Gym Policies and Contract and will abide by all of its provisions. *