EmailMe Form - Summer Program Application

Child's First and Last Name *

First Last

I agree to the following Conditions of Enrollment

CONDITIONS OF ENROLLMENT
In consideration of my membership in Two Jacks, Inc., dba GymCats and dba NinjaCats, and Chiara LLC dba Equalize Fitness, from here on known as GCNC, and my participation in GCNC Summer Program events and activities, I agree to be bound by each of the following:

Eligibility: I agree to comply with the rules of GCNC.

Payment must be made in full.

No refunds will be given for absences, changes, or withdrawals.

All GCNC Summer Program fees are non-refundable.

Readiness to participate: My child(ren) will only participate in GCNC classes, programs, events, competitions, and activities for which I believe they are physically and psychologically prepared. Prior to participation, my child(ren) will have practiced their exercises and will perform only those exercises which they have accomplished to the degree of confidence necessary to assure they can perform them safely, independently and without injury.

All pictures/videos of my child(ren) may be used for promotional use.

I agree to the following Medical Attention Terms *

Medical Attention: I hereby give my consent to GCNC to provide medical attention to my child(ren), in the event that the parent cannot be reached, through medical staff of its choice, customary medical/athletic training attention, transportation, and emergency medical services as warranted.

I agree to the following Waiver and Release Terms *

Waiver and Release: I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, and even death, as well as other damages and losses associated with participation in gymnastics, obstacle course activities, and summer program events.

I agree to the following GCNC RULES & POLICIES *

Children may be dropped off no earlier than 8:50 AM (unless registered for early drop-off) and no later than 9:00 AM.

Children will only be released to a parent or guardian unless other arrangements have been made with the office.

Children’s belongings should be kept in a tote bag or backpack. Valuables should be left at home. GCNC assumes no responsibility for lost or stolen items.

Please do not send ill children to GCNC. We reserve the right to send home any child who appears to be in poor health or poses a risk to other children.

Attire:

Girls: Leotard & barefoot (non-slip socks permitted). Close-fitted shirt/shorts may be worn over leotards. (as long as it does not hinder spotting) Hair must be secured. No jewelry (post earrings allowed).

Boys: Close-fitted gym shorts or pants, close-fitted shirt, barefoot (non-slip socks permitted).

For safety, no child may participate unless properly attired.

Please notify us if your child will be absent. The office opens at 8:00 AM.

Children should bring their own snack, lunch, and water bottle each day.

GCNC is not responsible for curriculum changes beyond our control.

GCNC may use inflatables during the program.

Signature - As the parent and/or legal guardian of the named child, I acknowledge that I have read and consent to the terms, conditions, and policies of GCNC. *

Clear

First and Last Name of Parent or Legal Guardian *

First Last

Child and Parent Contact and Emergency Information

Child's Name

First Last

Home Address of Child *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Date of Birth of Child *

MM / DD / YYYY

*

Gender

Home Phone

### - ### - ####

Primary Email

Restrictions *

Please list any medical restrictions, allergies, medications, health conditions, or other important medical notes that our staff should know to ensure your child’s safety.

Parent/Guardian Information

Parent/Guardian 1 *

First Last

Mobile Phone of Parent/Guardian 1 *

### - ### - ####

Occupation of Parent/Guardian 1

Parent/Guardian 2

First Last

Mobile Phone of Parent/Guardian 2

### - ### - ####

Work Phone of Parent/Guardian 2

### - ### - ####

Occupation of Parent/Guardian 2

Emergency Contact

Parents will be contacted first.

Emergency Contact Name

First Last

Emergency Contact Mobile Phone

### - ### - ####

Mobile Phone of Secondary Emergency Contact

### - ### - ####

Relationship

Secondary Emergency Contact Name

First Last

Relationship