Waiver and Release of Liability Form for Minor Children

What type of event are you coming to?*

Open Gym
Birthday Party
Other

Event Date*

Who's Birthday Party are you coming to?*

What event are you coming to?*

Parent/Legal Guardian Full Name*

First Middle Last

Address*

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

1) Minor's Name*

First Middle Last

1) Minor's Birth Date*

2) Minor's Name

First Middle Last

2) Minor's Birth Date

3) Minor's Name

First Middle Last

3) Minor's Birth Date

4) Minor's Name

First Middle Last

4) Minor's Birth Date

5) Minor's Name

First Middle Last

5) Minor's Birth Date

6) Minor's Name

First Middle Last

6) Minor's Birth Date

DISCLAIMER*

Oshkosh Gymnastics & Cheer, LLC (OGC) is not responsible for any injury (or loss of property) to any person while participating in open gym, special events, demonstrations or shows, or in any other way involved in gymnastics, cheerleading, Ninja Zone, birthday parties, private lessons and open gyms at OGC for any reason whatsoever, including ordinary negligence on the part of OGC, its members, managers, agents, or employees.

CONSENT*

I consent to my/minor's participation in the activity and acknowledge that I fully understand my/minor's participation may involve risk of serious injury, illness, or death, including losses which may result not only from my/minor's own actions, inactions or negligence, but also from the actions, inactions, or negligence of others, the condition of the facilities, equipment, or areas where the activity is being conducted, and/or the rules of play of this type of activity. I understand that if I have any risk concerns, I shall discuss them completely with the staff before I sign this agreement and before my/minor's participation in the activity begins.
Knowing and understanding the risks involved with participation in the activity, I hereby voluntarily and willingly assume full and complete responsibility for all losses and damages, including injury, illness, and death, resulting from my/minor's participation in the activity, including transportation to and from the activity. I agree I am financially responsible for any losses and damages resulting from my/minor's participation in the activity.

WAIVER*

In consideration for my/minor's participation in the activity, I hereby waive all claims or causes of action, including ordinary negligence, against OGC, its managers and members, and any of their employees, teachers, coaches, or agents, arising out of my/minor's participation in the activity wherever, whenever or however the same may occur.
I understand this waiver is intended to be as broad and as inclusive as permitted by the laws of the State of Wisconsin and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be within the State of Wisconsin.

CONCUSSION AWARENESS*

I understand the common signs, symptoms, and behaviors associated with head injury/concussion. If a concussion is suspected:
* My child must be removed from Activity.
* It is my responsibility to seek medical treatment for my child.
* My child must not return to Activity until providing written clearance from an appropriate health care provider.

MEDICAL AUTHORIZATION*

I give permission for Oshkosh Gymnastics & Cheer, LLC 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.

PHOTO & VIDEO RELEASE*

I understand and agree that my/minor's picture can be taken or be filmed while participating in activities at OGC or when representing OGC at events. I hereby grant to OGC, and its agents, employees and photographers, the right to take, use, publish, and copyright photograph(s) and videos of me/my minor's in press releases, advertisements, publications, and/or promotions of OGC, including on OGC's website and on social media websites, such as Facebook, Instagram and YouTube, maintained by OGC and/or its individual employees and/or agents. I hereby release and waive OGC, and its agents, employees, photographers and videographers, from any and all claims or demands arising out of or in connection with said photographs or videos or the publications of said photographs or videos.

AGREEMENT*

I have read this form and fully understand that by signing this form, I am giving up legal rights and or remedies which may be available to me/minor for the ordinary negligence of OGC or any person listed above. I affirm that I am of legal age and am freely signing this agreement.

Electronic Signature Consent*

By agreeing here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By agreeing here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes if necessary.

Parent or Legal Guardian*

Please confirm you are the parent or legal guardian for all minor children listed on this form.

Signature*

By signing below the Parent or Legal Guardian agrees that they are also subject to all terms of this document as set forth above.

ENTER TELEPHONE NUMBER TO REACH YOU IN CASE OF INJURY, ILLNESS or OTHER EMERGENCY SITUATIONS*

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Waiver and Release of Liability Form for Minor Children

Waiver and Release of Liability Form for Minor Children

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