Brick House Cheer, Gymnastics & Tumbling Event Waiver

Parents/ Gaurdian Info:

Full Name*

Parent first Parent Last Name

Parent Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

E-mail*

example@example.com

I agree

I agreeSigning for myself/ child

Please list your children's date of birth, first and last name: (if none please put your name)*

Rows	Full Name	Date of Brith
1
2
3
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I understand and assume all risks associatedwith participating at Brick House Cheer Gymnastics & Tumbling. I further agree to hold the Brick House Cheer Gymnastics & Tumbling Center and its employees, representatives, coaches, volunteers, owners and agents harmless in any and all liability actions, claims or additions legal actions in connection with participation in any activities related to the Brick House Cheer Gymnastics & Tumbling CenterI am physically able to participate, and I am legally competent to understand and complete and comply with this agreement. Brick House Cheer Gymnastics & Tumbling does not carry medical insurance for its students/athletes. It is required that all students/athletes/participants be covered by their own medical insurance policy. Brick House Cheer Gymnastics & tumbling is not responsible or liable for any injuries under any circumstances. In signing this agreement, I assume all responsibility for myself/my child/athlete while on site or at any other off-site event associated with a Brick House Cheer Gymnastics and Tumbling event.I understand that Brick House Cheer Gymnastics & Tumbling has video surveillance on site indoors and outdoors for our staff’s protection and safety as well as all our students & athletes protection safety.I give permission for Brick House CheerGymnastics & Tumbling to make photos or videos of me/ my students/athletesand staff for social media, advertising, TV, and publicity purposes with nocompensation.

I have read all policies above and fully understand and will abide by these setpolicies. In signing this agreement, I assume all responsibility for my child/student/athlete while on site or at any other off-site event associated with a Brick House Cheer Gymnastics and Tumbling event. *

You MUST be 18 years old or older to sign your own waiver. You MUST be the Parent or Legal Guardian to sign for a minor (under age 18)

We reserve the right to review your license and/or other forms of ID to verify identity and age.*

Brick House Cheer, Gymnastics & Tumbling

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