725 Main St. Millis, MA 02054

Permission to participate

Please note:
This form should NOT be used to register for trials, classes, or open gyms! If you are enrolling for a trial, class, or open gym, please use the “Schedule/register" button on the appropriate program or event page.

Main information

for example, John Doe's Birthday or Westwood School's Fundraiser
:

Parent/Guardian Information

Participant(s) Information

Release of Liability

RELEASE OF LIABILITY/INDEMNITY FOR PERSONAL INJURY –

I, for myself and/or my child and/or ward, hereby release, discharge, and covenant not to sue Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy, its owners, instructors, employees, agents and servants, and the owners, lessors and tenants of the premises located at 725 Main Street, Millis, Massachusetts (the “Premises”), and their present and former officers, directors, shareholders, members, owners, beneficial owners, managers, trustees, employees, representatives, assigns, heirs, parent entities, subsidiaries, contractors, and affiliates  (each considered a “RELEASEE” herein) from any and all liability, claims, demands, losses, or damages on account of personal injury to me and/or my child and/or ward caused or alleged to be caused in whole or in part by the negligence of the RELEASEES arising out of or in the course of or in any way related to my or my child's use of the Premises (including, but not limited to, the use of the facilities, parking area, equipment, and apparatus in or at the Premises) and/or my or my child's participation in any class, program, competition or other event organized, run and/or sponsored by Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy, whether at its facilities or elsewhere. On behalf of myself and my child and/or ward, I agree to indemnify and hold harmless the said RELEASEES from any and all claims, damages, demands, costs, expenses and compensation arising out of or in the course of or in any way related to any personal injury to me or my child.

 

PARENTAL CONSENT

I, the minor’s parent and/or legal guardian, understand the nature of the above referenced activities and the Minor’s experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, covenant not to sue and agree to indemnify and save harmless each of the RELEASEES from all liability, claims, demands, losses or damages on the minor’s account caused or alleged to have been caused in whole or in part by the negligence or claimed negligence of the RELEASEES and further agree that if, despite this release, I, the minor, or anyone on the minor’s behalf makes a claim against any of the above RELEASEES, I will indemnify and save and hold harmless each of the RELEASEES from any litigation expenses, attorney fees, loss liability, damage, or cost any RELEASEES may incur as the result of any such claim.

 

USE OF IMAGES/NAME IDENTIFICATION

I authorize Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy,  to use images of me and/or my child and/or ward, both with and without name identification, for Levon’s Gymnastics and/or Massachusetts Elite Gymnastics Academy publicity, promotional and advertising purposes and release any and all claims and/or rights I and/or my child and/or ward might have as a result.

 

ACKNOWLEDGEMENT OF ACTIVITY RISKS

1. I acknowledge that the activities offered by Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy  include active sports which can result in injury to participants and/or spectators. I recognize potential injuries that may occur in gymnastics, especially trampolining, with the amount of head inversion required in somersaulting tricks, as well as on other gymnastics equipment and events, particularly with the increasingly complex routines being developed.

2. I acknowledge that Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy provides an observation area and that I have the option to remain in the observation area while my child and/or ward is in a class, working out or performing.

3. That in the event I choose to leave my child and/or ward before, during or after a class, workout or a performance, I hereby give Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy my permission to use its discretion in determining whether my child and/or ward requires medical attention and, if so, to use its discretion in transporting my child and/or ward, selecting a health care facility and obtaining treatment for him/her.

4. I acknowledge that in my absence Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy does NOT assume any responsibility for the care, custody, control, condition, health or well being of my child and/or ward.

 

ACKNOWLEDGEMENT OF RULES AND POLICIES

I Acknowledge that Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy has rules and policies in place regarding safety, use of facilities, conduct and the like. I have reviewed all policies currently in place (copies always available at Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy). I understand that failure to follow the rules may result in revocation of all privileges provided by Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy without refund of any prepaid fees.

I have read the foregoing AUTHORIZATIONS, RELEASES AND ACKNOWLEDGEMENTS and have been given an opportunity to speak with a representative of Levon’s Gymnastics, Inc. dba Massachusetts Elite Gymnastics Academy before signing below.