Parent/Guardian Waiver and Release

Dear Parents:

We are pleased that your child has been invited to a birthday party at Gymnastics Village. Our facility is an exciting place for a child to have FUN. All of our parties are structured under the supervision of one or more of our staff members.

Before your child attends the party, you must fill out the information below, print the form and return it to the party host.

THIS FORM MUST BE SIGNED OR YOUR CHILD WILL NOT BE ABLE TO PARTICIPATE!

Child's Name:

Parent's Name:

Street:

Street (con't):

City:

State:

Zip:

Home telephone:

Birthday Party Child:

Parent/Guardian Waiver and Release: I fully understand that Gymnastics Village staff members are not physicians or medical practitioners of any kind. With the above in mind, I hereby release Gymnastics Village to render temporary first aid to my child in the event of any injury or illness, and if deemed necessary by the Gymnastics Village staff to seek medical help and/or call an ambulance. You agree that you are aware that your son/daughter will be engaging in physical exercise involving sports and fitness which could cause injury to them. You agree that your son/daughter is voluntarily participating in these activities and is assuming all risks of injury that might result. You hereby agree to waive any claims or rights that you might incur as a result of these activities. Gymnastics Village will make no evaluation or recommendation whether your son/daughter is physically fit for any physical activity. If your son/daughter has any physical condition that may impair his/her ability to engage in the activities, it is your responsibility to obtain a physician's statement describing any limitations to participate in this program. It is always advisable to consult a physician prior to undertaking any physical excretes program.

Signature: ________________________________    Date: _____________

Above Signature and Date must be signed at Gymnastics Village

Attire:
All participants should wear clothing suitable for gymnastics activity: leotard, shorts/T-shirt, no socks or shoes. Please, no belts, jewelry, buckles or dresses.

Directions:
1) From Nashua - 101A West to Caldwell Drive (Frederick's Pastries and Monro Muffler). Turn Left, go over the railroad tracks down to the circle. Gymnastics Village is almost halfway around the circle. Look for all of the SUVs and minivans.

2) From Milford - 101A East to Caldwell Drive (Frederick's Pastries and Monro Muffler). Turn Right, go over the railroad tracks down to the circle. Gymnastics Village is almost halfway around the circle. Look for all of the SUVs and minivans.

Gymnastics Village
13 Caldwell Drive, Amherst, NH 03031
Telephone: 603-889-8092   FAX: 603-598-4616
e-mail: judy@gymnasticsvillage.com