Registration
1 child =$27; 2 siblings = $47; 3 siblings = $67; 4 siblings = $80 | Non-Members = $40/child | Late pick up fee of $15/15 minutes (automatically charged to card on file). *****BEFORE CALLING****PLEASE NOTE**** DISCOUNTS WILL BE MANUALLY DEDUCTED BY STAFF PRIOR TO PROCESSING YOUR CREDIT CARD. **** YOU WILL NOT BE CHARGED THE NON-MEMBER AMOUNT UNLESS APPLICABLE.****
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)
 
 
Students entered below will be added to your family's account
 
Questions/Options:
MAKE-UP OPTION: Please type in the date of the missed class and the fee will be adjusted. One make-up per session permitted.
I understand that C.I.T.Y. Club staff will manually deduct applicable discounts prior to my credit card being charged.*
Promo Code, Coupon or Postcard Description, or Gift Certificate Code
 
Additional Information:
 
LIABILITY WAIVER
1) The undersigned will be present at and participate in activities at C.I.T.Y. CLUB GYMNASTICS ACADEMY. Such activities may include, but without limitation, instruction, training and competition in the sport of gymnastics, social and recreational activities, lodging, meals, transportation and other services (any and all of the foregoing are referred to in this document as "Activities"). 2) In consideration of participating in the C.I.T.Y. CLUB GYMNASTICS ACADEMY I represent that I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in the Activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the "releasees" named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the Activity. 3) I hereby release, discharge, and covenant not to sue C.I.T.Y. CLUB GYMNASTICS ACADEMY, its respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the " releasees", or otherwise, including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of releasees, I indemnify, save, and hold harmless each of the Relesees from any loss, liability, damage, or cost, which any may incur as the result of such claim. 4) FOR PARTICIPANTS OF MINORITY AGE. This is to certify that I/we, as parent(s)/legal guardians(s) with legal responsibility for the Participant, do hereby consent and agree not only to his/her assumption of risk, waiver, release and indemnification, but also for myself/ourselves, and my/our heirs, personal representatives, administrators, successors and assigns, to waive, release and indemnify C.I.T.Y. CLUB GYMNASTICS ACADEMY and "releasees" from any and all Claims incident to my/our child's participation in the Activities as stated above, even if arising from the negligence of C.I.T.Y. CLUB GYMNASTICS ACADEMY or one of the "releasees" to the fullest extent permitted by law. 5) I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I 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.
I've read the above and agree.
 
PEANUT/TREE NUT POLICY
A number of children who attend C.I.T.Y Club Gymnastics Academy have severe allergies. Within this group are children that have a potentially life threatening allergy to peanuts and tree nuts. Therefore, they must avoid all products with peanut of nut ingredients or nut oils. Ingestion of a piece of nut - containing food as tiny as a crumb, or contact with equipment which have been touched by others who have nut residue of their hands could trigger an anaphylactic, life threatening allergic reaction.
I've read the above and agree.
 
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Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
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