2019 Summer Camp Field Trip Waiver
Only ONE waiver is required per family. Please check the boxes to indicate the appropriate field trips your child/children will be attending.

* Required fields are marked with an asterisk.
  • Enter 1st child's name
  • Enter 2nd child's name
  • Enter 3rd child's name
  • Enter 4th child's name

    Below check the Field Trips your child/children will be attending.
  • Must sign Rockin' Jump's waiver online.
  • Must sign Westchester Circus Arts' waiver online.
  • Parent's name or main guardian's name
  • - -
    Mother's cell phone or main guardian's cell phone
  • - -
  • Emergency contact other than parent or guardian
  • - -
    Emergency phone number other than parent or guardian
  • Please let us know of any special information or request

    Read below and check marked boxes to confirm.
  • PAYMENT: No registration will be valid without payment.

    CLOSURES: The gym may be closed due to inclement weather or some other reason. Call (914)238-4967 or visit our website for closure details and updates at worldcupgymnastics.com.

    REFUNDS/CREDITS: No refunds will be given past the deadline date provided to us for the scheduled Field Trip. Exceptions are only allowed with a doctor's note.

    WHILE AT WORLD CUP GYMNASTICS FIELD TRIP: Parents and non-participating siblings are not allowed to travel with the Camp. Spectators may observe on their own. Do not call out or distract your child during the Field Trip. Have your children obey the Bus Rules and Policies at all times. Have your children obey the Field Trip Facility Rules and Policies at all times. World Cup is not responsible for any lost or stolen items. Valuable items may be left with the front desk.
  • WAIVER: World Cup and its staff recognize our obligation to make our clients aware of the risks and hazards associated with Jumping, Bouncing, Bowling, Climbing, etc. World Cup Gymnastics and its staff will not accept responsibility for injuries sustained by any child, parent and/or caregiver during the course of any activity and/or while arriving or departing or waiting anywhere on World Cup Gymnastics premises. Parents and/or caregivers should be aware of, and educate their children about the possibility of injury. Parents and/or caregivers should also encourage their children to follow all safety guidelines and World Cup staff instructions. Students, parents and/or caregivers may suffer injuries, possibly minor, serious or catastrophic in nature.

    Therefore, being fully aware of the risks and possibility of injury involved, I consent to have my child and/or myself participate in the programs offered by World Cup Gymnastics. I waive and release all rights and claims for damages that I or my child may have against World Cup Gymnastics and/or its representatives and staff, whether paid or volunteer. With this in mind, in the event of an injury or illness to my child or myself, and with the knowledge that World Cup staff members are not physicians or medical practitioners of any kind, I consent to the administration of temporary first aid to me and/or my child by World Cup staff if they deem necessary, contacting a doctor and/or seeking medical help, transportation by a World Cup staff member and/or its representatives, whether paid or volunteer, to any health care facility or hospital, calling 911 and/or an ambulance, etc. I also affirm that I now have and will continue to provide proper hospitalization, health and accident insurance coverage which I consider adequate for both my child's and/or my own protection. I also understand that it is my responsibility to continually remind my child about the dangers of Jumping, Bouncing, Bowling, Climbing, etc. injury. World Cup Gymnastics staff members will continually remind the children, parents and/or caregivers of safety guidelines during our programs, as well as post signs throughout the premises.

    PHOTO RELEASE: I authorize that World Cup Enterprises LLC has the right to use all photographs or videos taken of my child or children during Camp Field Trips, etc. for advertising or promotional materials, or on its website.
  • I accept World Cup's Rules/Policies, Waiver/Release & allow my payment to be processed by World Cup administration.