Summer Developmental Team Camp at MEGA for competitive gymnasts training level 4 or Xcel Gold & under.
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info
Students entered below will be added to your family's account
What gym does your gymnast attend?
What level did your gymnast compete last season?
What level does you gymnast hope to compete this season?
T-shirt size?
Additional Information:
Risk and Waiver of Liability
As the legal parent or guardian, yes, my daughter/son has my permission to attend classes/activities at B&T Gym, LLC dba Missouri Elite Gymnastics Academy (MEGA). In addition, my child/ward and I are participating in gymnastic, cheer, tumbling or other classes/activities under the terms and conditions set out below.

To the extent permissible by law, I/we hereby release, discharge and/or otherwise hold harmless and indemnify MEGA, it's owners, officers, directors, employees and associated personnel, from and against any and all demands, claims and causes of action arising, directly or indirectly, from my or my child's/ward's participation in its programs. THIS RELEASE SPECIFICALLY INCLUDES ANY DEMANDS, CLAIMS AND CAUSES OF ACTION ARISING OUT OF THE PAST OR FUTURE NEGLIGENT ACTS AND/OR OMISSIONS OF MEGA, ITS OWNERS, OFFICERS, DIRECTORS, EMPLOYEES AND ASSOCIATED PERSONNEL.

I've read the above and agree.
Medical Emergency
I give permission for MEGA owners, officers, employees, and/or agents to seek emergency medical treatment for the participant(s) in the event they are unable to reach any parent or guardian. The undersigned also agrees that they themselves will be responsible for any financial debt incurred by said action.
I've read the above and agree.
Marketing Release
Occasionally MEGA uses photos or video of its students and guests in print ads, on its website, or other marketing mediums. I understand that my child's likeness may be used in such advertising. These images will be used for MEGA purposes only and will not be given or sold to outside companies or individuals.
I've read the above and agree.
Parent/Guardian Signature
I have read and understood the above RISK AND WAIVER OF LIABILITY and MEDICAL AUTHORIZATION and MARKETING RELEASE. In addition, I confirm that I am the parent/legal guardian of this registrant(s).
I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments: