SUMMER SPECIAL SIGN UP

Preschool: Ages 3 and 4 - basic skills, learning body awareness, rolls, beginning cartwheels

Introduction to tumbling - learning and perfecting cartwheels, rolls, handstands

Level 1 - learning and perfecting Front and Back walkovers, round-offs (must already have cartwheel, rolls and handstands)

Level 2 - learning and perfecting front and back handsprings (must have all level 1 skills to enroll)

Level 3/4 - learning and perfecting tucks and above (must have all level 2 skills to enroll)

Athlete First Name *

Athlete Last Name *

SUMMER CLASS SPECIAL!

Ages 3-18

A one time payment of $149.00 includes 12 weeks of unlimited tumbling, stretch/strengthen top girl and stunt class. Take as many classes as you want each week.(Tumbling classes must be chosen based on your athletes current skills, but we offer multiple classes each week for each level.) You must pre-register for the classes so we have the correct athlete:coach ratio. ($50.00 yearly registration fee applies to new athletes)

This offer is valid May 31 - Auguest 5 (accounts for our one week closure in July).

Phone 850.898.3366 or email info@gulfcoastelitecheer.com

Athlete Date of Birth * +

Street Address *

Address Line 2

City *

Zip Code *

Phone Number *

Parent's first name *

Parent's last name *

Parent Email Address *

It is ok to email me updates or changes

Emergency Contact: (first and last name) *

Emergency contact phone *

Does your child have any allergies? *

Payment Information *

$149.00 Unlimited summer special

$50.00 yearly registration fee (for new athletes)

Will send in cash/check upon athletes first class

BY entering my credit card info, I authorize Gulf Coast Elite to charge my card for the amount listed above.

Name on Card

Credit Card Type

Credit Card Number

Expiration Date (mm/yy)

CID number

Zip code associated with card

By checking this box, you acknowledge that you have read and agree to the following:

Assumption of Risk, Release of Liability for Personal Injury, Medical Authorization I, for myself and as the parent and/or legal guardian of minor child, do hereby release Gulf Coast Elite Cheer, its owners, operators, instructors, employees, agents, servants and affiliates from any and all liability or in any way related to my or my child’s use of the facilities, equipment, or apparatus of Gulf Coast Elite Cheer; and /or my or my child’s participation in any class, program, competition or other event organized, run and/or sponsored by or held by Gulf Coast Elite Cheer, hold harmless the said claims, demands, costs, expenses and compensation arising out of or in the course of or in any way related to any personal injury to me or my child. By signing this release, I acknowledge my understanding and acceptance of the following: 1. That gymnastics/tumbling/cheerleading is an active sport, which requires strength, agility and concentration and that it is solely my responsibility to determine that my child is in good health and good physical and mental condition before permitting my child to exercise, work out, receive instruction or perform. 2. That gymnastics/tumbling/cheerleading requires twisting, turning, tumbling, jumping, flexion, extension and rotation, which movements are often performed with considerable force and/or at considerable height and which can result in severe, permanent personal injuries, including, but not limited to, bruised, strained, sprained or torn muscles, tendons and ligaments, broken bones, derangements or dislocations of joints, concussion, brain damage, nerve and spinal cord injury, paralysis and death. 3. That gymnastics/tumbling/cheerleading requires the use of apparatus and equipment, which may cause or contribute to severe, permanent personal injuries, such as those described above. In the event of an accident or emergency I would like my above mentioned child to be taken to a hospital for medical treatment and I hold Gulf Coast Elite Cheer and its representatives harmless in their execution of this action. Additionally, I hereby agree to individually provide for all possible future medical expenses which may be incurred by my child as a result of any injury sustained while participating with, at or for Gulf Coast Elite Cheer. I and participant(s) have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, and understand that I and participant(s) have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect. And I, as the minor’s parent and/or legal guardian, understand the nature of the above referenced activities and the Minor’s experience and capabilities and believe the minor to be qualified to participate in such activity *

By checking this box, I acknowledge that I have read and agree to the following:

MEDICAL RELEASE FORM I fully understand that Gulf Coast Elite Cheer and staff are not physicians or medical practitioners of any kind. With the above in mind, I hereby release the staff of Gulf Coast Elite to render temporary first aid to my child or children in the event of any injury or illness, and if deemed necessary by the staff of Gulf Coast Elite , to call a doctor and seek medical help, including transportation to any health care facility or hospital, or the calling of an ambulance for said child should the staff of Gulf Coast Elite deem it necessary. We, the staff of Gulf Coast Elite, recognize our obligation to make our clients and their parents aware of the risks and hazards associated with the sport of cheerleading. Competitors may suffer injuries, possibly minor, serious or catastrophic in nature. These activities can be dangerous and can lead to injury. It is the parents who should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and coaches’ instructions. The undersigned agree, Gulf Coast Elite Cheer Inc. and its’ staff members are not responsible for injuries sustained by any cheerleader during the course of tumbling, stunting, cheerleading, or dancing in which he/she may participate or while traveling to or from the event. With the above in mind, and being fully aware of the risks and possibility of injury involved, I consent to have my child or children participate in the programs offered by Gulf Coast Elite. I, my heirs, executors, and other representatives, waive and release all rights and claims for damages that I or my child/children may have against Gulf Coast Elite Cheer Inc. and or its’ representatives whether paid or volunteer. I also affirm that I now have and will continue to provide hospitalization, health and accident insurance coverage that I consider adequate for both my child’s protection and my own protection. *

Printed name of Parent or Legal Guardian: (printing your name means that you agree to the terms stated herein and that all information is correct and current. Please let us know if any information changes) *

Parent or legal guardian signature: *

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Date signed: * +

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