AMERICAN EAGLES GYMNASTICS STUDENT REGISTRATION FORM
Student's Name:_________________________________Sex:____Date of Birth:__________________
Age:_____Grade:_____School:___________________________________________________________________
Home address/street/city/st./zip:__________________________________________________________________
Home Phone #:_______________________Emergency Phone#:________________________
Mother's Name:____________________________________Father's
Name:_________________________________
Past Gymnastics
experience:_______________________________________________________________________
Does your child have any special medical considerations
or limitations that our Instructors should be aware of?______y/n, If yes explain below:
_________________________________________________________________________________________________
Please
tell us how you first heard of American Eagles Gym? If a friend mentioned our program, please share their name:____________________________________________________________________________
If
this is a "mail in" registration, please specifically list your desired class choice, level, day and time!
We need an actual signature, so please sign before mailing
or bring it to the gym. Because of this, we cannot except email registrations.
***Assume
that your registration for that class has been accepted unless otherwise notified***
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_____________________________________________________________________________________________
**On above line state your child's name, specific class level, day and time along with your 2nd choice
of day and time
Waiver
of Liability
Any activity involving height or elevated
motion incurs the possibility of accidental injury. While it is our express intention at American Eagles Gymnastics,
Inc. to provide for the safety and protection of your child, it is expressly asserted that American Eagles shall not be held
liable for any injury sustained while your child is under our instruction, supervision, or control. The parents of______________________ hereby agree to individually protect the possible future medical
expense incurred as a result of any injury sustained while training or performing at or for American Eagles Gymnastics, Inc.
Parent's Signature:_________________________________________________________Date:____________
