Olympic Kids Gym Class Registration

Olympic Kids Gym Class Registration

*Please complete a separate registration form for any additional siblings.
Participant Information: Child
Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender

Parent/Guardian Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com

Health
Does your child have any current injuries or medical conditions?
(e.g., back pain, joint issues, heart conditions)
Is your child currently on any medications that affect physical performance?
Is there anything we should know about to help your child have a positive experience?
Media Permission and Liability
I authorize Olympic Fitness Center to use photos/videos of my child for promotional materials.
WAIVER OF LIABILITY: I on behalf of myself and my children hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Olympic Fitness Center LLC its owners and employees from any and all claims, demands, or causes of action which are in any connected with my participation in this activity or my use of their equipment or facilities arising from negligence. Should Olympic Fitness Center LLC its owners or employees be required to incur attorneys fees and costs to enforce this agreement I agree to indemnify and hold them harmless for all such fees and costs. I understand that there is risk involved in physical activities including risks of bodily injury, partial or total disability, paralysis and death as well as other foreseeable and unforeseeable damages including damage to property. I understand that there is also a very remote possibility that I might be exposed to bodily fluids. I knowingly and voluntarily acknowledge my full understanding of said risks and assume such risks on behalf of myself and my family and guests. I hereby give authorization to Olympic Fitness Center LLC staff to act in accordance with their best judgment in case of any injury or emergency that may occur for me, my family, or guest. Should medical care be necessary, I agree to pay the reasonable cost of such medical care or treatment.

Registration Payment

My Products

1 Child Registration

$25.00

Additional Child Registration

*Please complete a separate registration form for any additional siblings then select this option upon payment. Thank you!

$15.00

Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Should be Empty:

Olympic Kids Gym Class Registration

Participant Information: Child

Parent/Guardian Information

Health

Media Permission and Liability

Registration Payment

My Products*

My Products