Drop-in Gym Waiver - California Sports Center
Drop-in Gym Waiver - California Sports Center
Drop-in Gym Waiver - California Sports Center
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Participant <strong>Waiver</strong> Form<br />
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND<br />
INDEMNITY AGREEMENT (“AGREEMENT”)<br />
In consideration of participat<strong>in</strong>g <strong>in</strong> programs at <strong>California</strong> <strong>Sports</strong> <strong>Center</strong> I represent that I understand the nature of this Activity<br />
and that I am qualified, <strong>in</strong> good health, and <strong>in</strong> proper physical condition to participate <strong>in</strong> such Activity. I acknowledge that if I<br />
believe event conditions are unsafe, I will immediately discont<strong>in</strong>ue participation <strong>in</strong> the activity. I fully understand that this<br />
Activity <strong>in</strong>volves risks of serious bodily <strong>in</strong>jury, <strong>in</strong>clud<strong>in</strong>g permanent disability, paralysis and death, which may be caused by my<br />
own actions, or <strong>in</strong>actions, those of others participat<strong>in</strong>g <strong>in</strong> the event, the conditions <strong>in</strong> which the event takes place, or the<br />
negligence of the “releasees” named below; and that there may be other risks either not known to me or not readily foreseeable at<br />
this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I <strong>in</strong>cur as a result of my<br />
participation <strong>in</strong> the Activity.<br />
I hereby release, discharge, and covenant not to sue <strong>California</strong> <strong>Sports</strong> <strong>Center</strong> its respective adm<strong>in</strong>istrators, directors, agents,<br />
officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of<br />
premises on which the Activity takes place, (each considered one of the “RELEASEES” here<strong>in</strong>) from all liability, claims,<br />
demands, losses, or damages, on my account caused or alleged to be caused <strong>in</strong> whole or <strong>in</strong> part by the negligence of the<br />
“releasees” or otherwise, <strong>in</strong>clud<strong>in</strong>g negligent rescue operations and future agree that if, despite this release, waiver of liability, and<br />
assumption of risk I, or anyone on my behalf, makes a claim aga<strong>in</strong>st any of the Releasees, I will <strong>in</strong>demnify, save, and hold<br />
harmless each of the Releasees from any loss, liability, damage, or cost, which any may <strong>in</strong>cur as the result of such claim.<br />
I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY<br />
AGREEMENT, understand that I have given up substantial rights by sign<strong>in</strong>g it and have signed it freely and without any<br />
<strong>in</strong>ducement or assurance of any nature and <strong>in</strong>tend it to be a complete and unconditional release of all liability to the greatest extent<br />
allowed by law and agree that if any portion of this agreement is held to be <strong>in</strong>valid the balance, notwithstand<strong>in</strong>g, shall cont<strong>in</strong>ue <strong>in</strong><br />
full force and effect.<br />
_____________________________________________<br />
Pr<strong>in</strong>ted name of participant<br />
Date:________________________<br />
PARENTAL CONSENT<br />
AND I, the m<strong>in</strong>or’s parent and/or legal guardian, understand the nature of the above referenced activities and the M<strong>in</strong>or’s<br />
experience and capabilities and believe the m<strong>in</strong>or to be qualified to participate <strong>in</strong> such activity. I hereby Release, discharge,<br />
covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees from all<br />
liability, claims, demands, losses or damages on the m<strong>in</strong>or’s account caused or alleged to have been caused <strong>in</strong> whole or <strong>in</strong> part by<br />
the negligence of the Releasees or otherwise, <strong>in</strong>clud<strong>in</strong>g negligent rescue operations, and further agree that if, despite this release, I,<br />
the m<strong>in</strong>or, or anyone on the m<strong>in</strong>or’s behalf makes a claim aga<strong>in</strong>st any of the above Releasees, I WILL INDEMNIFY, SAVE AND<br />
HOLD HARMLESS each of the Releases from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasee<br />
may <strong>in</strong>cur as the result of any such claim.<br />
PHOTO RELEASE<br />
I am aware that <strong>in</strong>dividual and group publicity photos and videos are taken from time to time and <strong>in</strong> consideration for my or my<br />
child(ren)’s participation I hereby grant my permission for my child’s likeness to be used <strong>in</strong> <strong>California</strong> <strong>Sports</strong> <strong>Center</strong> publicity or<br />
advertis<strong>in</strong>g.<br />
___________________________________________<br />
Pr<strong>in</strong>ted name of Parent/or Legal Guardian<br />
__________________________________________<br />
Signature of Parent/or Legal Guardian<br />
Date:_______________________<br />
___________________________________________<br />
Signature of <strong>California</strong> <strong>Sports</strong> <strong>Center</strong> Employee
<strong>Drop</strong>-<strong>in</strong> <strong>Gym</strong>: Participant Information<br />
Pr<strong>in</strong>ted name of participant _____________________________________ M / F Birth Date: ____________________<br />
CSC site where your child takes regular classes (please circle):<br />
Race St. Morgan Hill Malone Cambrianna Great Oaks<br />
Today’s Date: __________ My Child is: An Active <strong>Gym</strong>nastics Member Not currently enrolled: _________________<br />
My child’s current level is: _______________________________<br />
Emergency Contact Not on Site_____________________ Emergency Contact Number ________________________<br />
Are there any limitations or a medical condition our staff should be aware of No Yes (please describe)<br />
________________________________________________________________________________________________<br />
________________________________________________________________________________________________<br />
<strong>Drop</strong>-<strong>in</strong> <strong>Gym</strong> Rules<br />
Parents are encouraged to use this time to observe their kids <strong>in</strong> action. Remember, however, that our rules are to be respected<br />
by all parents who stay to observe. All participants must read and agree to the follow<strong>in</strong>g rules before jo<strong>in</strong><strong>in</strong>g us!<br />
1. CSC Instructors are <strong>in</strong> charge at all times. Participation is allowed only when follow<strong>in</strong>g the guidel<strong>in</strong>es of the <strong>in</strong>structors, and<br />
always under their supervision. Their concern first and foremost is the safety of the participants. Secondarily, they are<br />
there to assist participants, make sure activities occur <strong>in</strong> an organized fashion, and monitor the usage of events /<br />
equipment.<br />
2. Sign-<strong>in</strong> is required of all participants (even those members with a waiver on file).<br />
3. <strong>Drop</strong>-<strong>in</strong> <strong>Gym</strong> is open to Active <strong>Gym</strong>nastics Members ages 6-23, enrolled <strong>in</strong> Recreational Levels, Team Development, or<br />
Competitive Team. Preschool members (ParentTots, T<strong>in</strong>yTots, TumbleTots, and Pre-Rec students who are under the age of<br />
6 are NOT permitted to participate. (PLEASE NOTE: Team Development “SuperKids” students are the only children under<br />
age 6 allowed on the gym floor at Open <strong>Gym</strong>, and a parent is required to stay <strong>in</strong> the lobby.)<br />
4. FREE Participation for Currently Enrolled (“Active”) <strong>Gym</strong>nasts<br />
a. Annual or Monthly Membership – def<strong>in</strong>ed as be<strong>in</strong>g currently enrolled <strong>in</strong>, and actively attend<strong>in</strong>g, a regularly<br />
scheduled gymnastics class at least once a week at one of our private sites (our city site participants are not CSC<br />
Members).<br />
b. Sign-<strong>in</strong> by a parent/legal guardian, and hav<strong>in</strong>g an <strong>in</strong>dividual waiver on file<br />
c. Agree<strong>in</strong>g to these written rules.<br />
5. Trampol<strong>in</strong>e is required to be directly supervised by an Instructor at all times, and for safety reasons its usage will be<br />
restricted dur<strong>in</strong>g <strong>Drop</strong>-<strong>in</strong> <strong>Gym</strong>s.<br />
6. Equipment use & activity must be commensurate to each participant’s level. No unassisted flipp<strong>in</strong>g skills are permitted<br />
for any student below an advanced level (i.e. below Advanced Rec or Level 4). See an <strong>in</strong>structor for approved “flipp<strong>in</strong>g”<br />
progressions and progressions for other <strong>in</strong>verted activities. Participants should feel free to ask for guidance about what<br />
activities are appropriate, or for a copy of a Rec Level Skills Card for reference.<br />
7. Only CSC Instructors may assist or spot participants with gymnastics activities.<br />
8. General Safety Rules apply throughout the gym. No horseplay, rough hous<strong>in</strong>g, runn<strong>in</strong>g, push<strong>in</strong>g, misuse of equipment, or<br />
dangerous activities will be tolerated. Dismissal from <strong>Drop</strong>-<strong>in</strong> <strong>Gym</strong> for any of these reasons will be immediate, and return<br />
to activities will not be permitted that day.<br />
10. No food or dr<strong>in</strong>k is allowed on the gym floor at any time! Please enjoy dr<strong>in</strong>ks and snacks <strong>in</strong> our lobby area.<br />
Last updated 10/8/13 cdb