Parent Information *

Email *

Phone *

Student First Name

Student Last Name

My child has allergies or special health concerns *

Participant Date of birth *

Gender

Hospital/Clinic Preference *

Physician Name

Choose from: *

Mommy & Me Pilates Drop- In

Enjoy a 30 minute Mommy & Me Pilates session hosted by Sara Stevens, a specialist in prenatal & postnatal fitness

$20

Playdate Drop-in

Join us for Coffee, Donuts, and a fun time of gym exploration for ages 0-4!

$10

Pilates & Playdate Bundle Drop-in

Move your body with your little one through a refreshing Mommy & Me Pilates session followed by sweet laughter and fun during Diapers & Donuts!

$30

RELEASE OF LIABILITY

Please Check the boxes below and sign *

I give permission for myself , child, and any other family member to participate in Riverfront Gymnastics Center LLC’s programs. I fully understand and acknowledge that gymnastics and tumbling activities have inherent risks, dangers, and hazards that my child’s participation in such activities and/or use of such equipment may result in injury including, but not limited to bodily injury, strains, fractures, and other serious disabilities. I freely and voluntarily assume all risks inherent in my participation, my child's participation, and any other family members’ participation in these activities. I hereby agree to release and discharge Riverfront Gymnastics Center LLC and its agents, employees, owners, or representatives from any and all liability, claims, demands, causes of action, losses, damages, or injuries to any person or property, including serious injury or death, that may result while preparing for or participating in Riverfront Gymnastics Center LLC programs. This waiver will be binding upon my heir(s), next of kin, estate, executors and anyone claiming any rights on my behalf or my child’s behalf. By signing below, I represent and agree that I have read this document and fully understand that this document relieves Riverfront Gymnastics Center LLC of any liability, whether caused by my negligence, or by the negligence of Riverfront Gymnastics Center LLC, or any of its agents, employees, owners, or representatives. In case of an emergency, Riverfront Gymnastics Center has my permission to request medical attention for myself, my child, or any other family member. I understand and acknowledge that no medical insurance benefits will be provided to my child or myself during this activity and that I will be responsible for any medical bills that may result from my participation in gymnastics and/or tumbling.

I, being the parent or guardian of the participant, DO hereby authorize my child’s photograph to be used in advertisement for Riverfront Gymnastics Center LLC.

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Full Name

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.