JUMPIN GYMKIDS

Jumpin GymKids
409 N PCH
Redondo Beach, CA 90277
ph: 310-386-5626
JGK@jumpingymkids.com

REGISTRATION

Information

*Students First Name: (sibling(s) name)

If you are registering more than one child, you may add both names provided the address is the same.

*Students Last Name

Age and Grade of student:

Name of school:

*Which class(es):

Please click the drop down menu to choose your class(es).

*Name of Parents/legal guardian:

Please include the first and last name of mother and father.

*Address Line 1:

*City:

*ZIP/Postal Code:

*Email:

*Home Phone:

Work Phone:

Please only put work phone if you can receive calls at work.

*Cell Phone:

*Allergies:

Please list all allergies.

*Medical Conditions:

Please list any and all medical conditions.

*Waiver
I am aware that participation in this activity may be a potentially dangerous activity involving many risks of injury. I understand that the dangers include, but are not limited to, injury to ligaments, muscles, tendons, and other aspects of the body, which may include neck or spinal injury.
Because of the dangers of the activity, I understand the importance of following the coach and his or her instructions regarding techniques, training, and other rules, and agree to obey instructions. In consideration for allowing me to participate, I hereby assume all the risks associated with the sport of gymnastics and agree to hold the gym, its employees or agents harmless from any and all liability which may arise in connection with my participation in Jumpin' GymKids programs and activities.

I have read the above warning and release and understand its terms

Please keep in mind that we always e-mail you the pictures and/or videos prior to use for your approval.

*Photo/Video
release waiver
I hereby grant permission to Jumpin' GymKids to use my film/photo image for display on the Jumpin' GymKids web site and/or to use my film/photo image in any educational/instructional videos, CD-ROMs or printed materials developed and distributed by Jumpin' GymKids.

YES NO

Submit Your Registration

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Jumpin GymKids
409 N PCH
Redondo Beach, CA 90277
ph: 310-386-5626
JGK@jumpingymkids.com