Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Participants Name *FirstLastDate Attending *Select Event/Role *ClinicTeam PracticeGuest CoachAidOTHERIf OTHER please specify:Address, City, State & Zip *Phone # *Email *Date of Birth *Consent to Participate: I verify that I am in good health and able to participate at C.S. Gymnastics, Inc. in the above indicated activity. TYPE INITIALS BELOW: *Release and Waiver of Liability: I understand that while the sport of gymnastics can be a fun and enriching experience, participation in the above-indicated event, as well as any gymnastics program, carries with it the risk of injury, including catastrophic and permanent injury. I do hereby release, waive, discharge, and promise not to sue C.S. Gymnastics, Inc., its owner, coaches, instructors, and staff from and for any and all liability, claims, debts, or obligations of any kind, including liability for negligence, arising out of or related in any way to personal injury (including death), accidents, illnesses, and/or property loss, in connection with my participation in the above-indicated event, gymnastics activities, Ultimate Ninja Athlete (UNA) classes, team practice, and any other use of C.S. Gymnastics, Inc. premises, services, facilities, and/or equipment. TYPE INITIALS BELOW: *Assumption of Risks: Participation in Gymnastics or UNA carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injury. The specific risks vary from one activity to another, but the risks range from 1)minor injuries such as rips, blisters, scratches, bruises, and sprains, to 2) major injuries such as eye injury, joint or bone injuries, heart attacks, and concussions, to 3) catastrophic injuries such as paralysis and death. I acknowledge and assume the risk of my participation in the above-indicated event, gymnastics and/or UNA. TYPE INITIALS BELOW: *Indemnification and Hold Harmless: I also agree to indemnify and hold C. S. Gymnastics, Inc. harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, arising out of my child(ren)’s involvement in Gymnastics or UNA, and to reimburse it for any such expenses incurred. TYPE INITIALS BELOW: *Severability: I further agree that this Waiver of Liability, Assumption of Risk, and Indemnity Agreement is intended to be as broad and inclusive as permitted by law, and that if any portion is held invalid the remaining portions will continue to have full legal force and effect. TYPE INITIALS BELOW: *Governing Law and Jurisdiction: This Agreement shall be governed by the laws of the State of New Jersey, and any disputes arising out of or in connection with this Agreement shall be under the exclusive jurisdiction of the Courts of the State of New Jersey. TYPE INITIALS BELOW: *Acknowledgment of Understanding: I have read this Waiver of Liability, Assumption of Risk, and Indemnity Agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I confirm that I am signing the agreement freely and voluntarily and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. TYPE INITIALS BELOW: *I have read and understand this document in its entirety and agree to all terms set forth above. TYPE INITIALS BELOW: *Participant Signature *Clear SignatureDateSubmit