Back Handspring Clinics

Athlete's Name*

First NameLast Name

Athlete's Date of Birth*

Date

Parent's Name*

First NameLast Name

Phone Number*

E-mail*

example@example.com

Release of Liability - I hereby acknowledge and comprehend that any disputes arising with Rampage Athletics and its affiliated parties will be subjected to binding arbitration in Blue Springs, MO, in accordance with the laws of Missouri. I hereby consent to this binding arbitration as a substitute for any legal proceedings. Furthermore, I am aware and in agreement that if I challenge any decision or ruling made by Rampage Athletics and seek alternative remedies, I will be responsible for reimbursing Rampage Athletics for all reasonable legal fees and expenses incurred. In the event that any part of this agreement is deemed unenforceable, the remaining provisions shall continue to be fully effective. By signing below, I confirm that I have thoroughly read, comprehended, and voluntarily agreed to be bound by all the aforementioned terms, and that all information provided by me is accurate and truthful.*

I agree

Assumption of Risk - I acknowledge the inherent risk and danger of participation in any sport and I understand that participation in tumbling, cheerleading and/or dance may result in BODILY INJURY, PARALYSIS, BRAIN INJURY, PERMANENT DISABILITY AND/OR DEATH. I acknowledge that protective equipment does not prevent all participant injuries. I release, indemnify, hold harmless and waive any claim against the coaches, staff, and any and all organizers, sponsors, supervisors, participants, and persons transporting my child to and from activities, for any injury to my child whether the result of negligence or for any other cause.*

I agree

Photo Release -I hereby grant permission to Rampage Athletics to use photographs and/or videos of me/my child, taken during any activity, for the purpose of promoting and publicizing their activities. I understand that these images may be used in various forms of media, including but not limited to print publications, websites, social media platforms, and promotional materials. I acknowledge that I will not receive any compensation for the use of these photographs and/or videos. I also understand that once the images are published, they may be viewed by a wide audience and may be downloaded, shared, or used by others without the control or knowledge of Rampage Athletics. I release Rampage Athletics, its representatives, employees, and any third parties acting under its authority, from any liability or claims arising from the use of these photographs and/or videos. I have read and understood the terms of this consent form before signing it.*

I agree

Insurance Disclosure -I am aware that Rampage Athletics carries group accident medical insurance which is secondary or excess to my insurance which is considered primary insurance. Further, I agree to notify the president of any medical claim from participation in Rampage Athletics as soon as reasonably possible. I understand that the class fees is are not premium for insurance and that deductibles may apply.*

I agree

Medical Emergencies - I give permission for emergency medical/dental treatment or first aid to be administered to my child for any illness/injury/accident resulting from participation in Rampage Athletics activities.*

I agree

General Permission -I am the parent or legal guardian of the participant. I acknowledge that my child is in good health. I give permission for my child to participate in any and all Rampage Athletics activities, including transportation to and from the activities. I give permission for, and assume any and all risk of my child's use of various surfaces including natural and artificial grass, cheer mats, hard dirt, and under varying conditions, including, dry, wet and muddy, and I hereby understand that any surface may be regular or irregular.*

I agree

Signature*