Birthday Party Waiver

Name of Birthday Party *

Name *

First

Last

Cell Phone Number *

Mailing Address *

Email *

Child's Name *

First

Last

Date of Birth *

Gender

Insurance Carrier *

Any medical conditions *

Check on all Boxes *

This is to certify that my child has my permission to participate in gymnastics at Armory Athletics Center
I fully understand that students are not insured against injuries of any kind
I do hereby authorize Armory Athletics, its coaches, trainers, or any member of its staff to obtain emergency medical treatment from any physician, hospital, or other qualified medical personnel or facility as needed in the event of accident or injury.
I agree to take full responsibility in paying for any medical care that my child may have to receive if hurt while participating in gymnastics

Parent/Guardian Signature *

Date *

Phone