WAIVER OF LIABILITY
In consideration for allowing my child to participate in activities offered by Winterset Dance & Gymnastics Inc., I, my heirs and assigns, next of kin, and all others acting on my behalf agree to waive any and all rights, claims, damages, actions, causes of action or suits of any kind or nature whatsoever which I have or my child has against Holli Floden, Matt Floden, Winterset Dance & Gymnastics Inc., or any agent, employee, representative or other acting on their behalf and to indemnify, defend and hold harmless Holli Floden, Matthew Floden, Winterset Dance & Gymnastics, Inc.,or any agent, employee, representative or other acting on their behalf for any injuries suffered as a result of engaging in those activities offered by Winterset Dance & Gymnastics Inc.
It is also my intent to release Holli Floden, Matthew Floden, Winterset Dance & Gymnastics, Inc. and any agent, employee, representative, or other acting on their behalf from liability for ordinary or gross negligent conduct that may occur in the future and agree not to sue. Should any part or parts of this agreement be held null and void, the gross balance of the gross agreement shall remain valid and maintain its full force and effect.
This acknowledgment of risk and WAIVER OF LIABILITY has been read by me and understood completely and signed voluntarily. I am 18 years of age or older.
By agreeing to this I understand that even though I am not taking gymnastics, tumbling, or lessons and will not be on the equipment, I may injure myself being in the gym. I take full responsibility for my actions and agree to pay for all medical bills that might arise from an accident at Winterset Dance & Gymnastics, Inc. This could include, but not limited to, stepping off uneven mats and twisting an ankle, broken bones, torn ligaments, spine injuries, or even death. This includes outside the building in the parking lot and all surrounding areas.
I fully understand that the staff of Winterset Dance & Gymnastics, Inc. are not physicians or medical practitioners of any kind. With that in mind, I hereby release Winterset Dance & Gymnastics, Inc. to render first aid to my child in the event of any injury or illness, and if deemed necessary, to call an ambulance, which I agree to pay for. As a parent or legal guardian, I agree to provide health insurance for the minor child and guarantee payment of any medical expenses incurred as a result of training, performing, or participation in activities with Winterset Dance & Gymnastics, Inc.
MEDICAL DISCLOSURE
Parents are to disclose to Winterset Gymnastics in writing of any medical conditions (mental or physical) or medications we should be aware of, including but not limited to; breathing problems, seizures, allergies, Downs Syndrome, dizzy spells, previous neck or spine injuries or conditions, broken bones, high blood pressure, diabetes, autism, epilepsy, heart condition, etc.
***ALL ABOVE CONDITIONS REQUIRE A DOCTOR'S RELEASE claiming your child is fit enough to take "GYMNASTICS" and permitted to use “TRAMPOLINES”.
If my child requires an inhaler to be brought to class, I understand I am required to stay with him/her or get a doctor's release. I understand that Winterset Gymnastics may not be equipped to accommodate all medical and behavioral needs, and my request for enrollment may be denied. Please list and discuss with Holli medical conditions, medications taken regularly, and any behavioral diagnosis.
BEHAVIORAL DISCLOSURE
Any time a student’s behavior jeopardizes the safety of themselves, other students, or staff, we will require that the child be removed from the class. We are not equipped to accommodate behavioral needs.