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All Star Cheer
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Tumbling
Preschool Tumbling
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About Us
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SIGN UP FOR TUMBLING CLASSES TODAY
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Waiver
Waiver
WAIVERS
Whether you are coming for an open gym, a clinic, or a birthday party, you need to have a waiver on file. Please fill out a waiver below to make your visit as seamless as possible!
CHILD WAIVER
ADULT WAIVER (18+)
Please Complete The Child Waiver Below
WAIVER AND RELEASE OF LIABILITY AND CONSENT TO MEDICAL SERVICES
In consideration of being allowed to participate in any program, class, team event, tryout, gym/mat rental etc. at Funkytown Cheer Factory, LLC, including any related events and activities, the undersigned acknowledges, appreciates, and agrees that: I hereby consent to myself and all family members participating (including those not listed below) in Funkytown Cheer Factory's program(s). I recognize that potentially severe injuries can occur in any activity involving height or motion, including tumbling and related activities including cheerleading, tumble tramp, trampoline, stunting, pyramids, dance, gymnastics, martial arts, playing on inflatables/bounce houses and physical activity in general. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID19) from the activities involved in this program are significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and, I am aware that coaching cheerleading, tumbling, etc. requires the coach to physically touch me. Whether it is demonstrating a technique, spotting, or catching a falling athlete, I understand that coaches are often required to engage in physical touch in order to adequately do their job In the event of an emergency, I understand that delays in contact medical services can lead to potential risk. Therefore, I authorize Funkytown Cheer Factory, LLC to contact medical services on my behalf to ensure the fastest medical attention possible. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Funkytown Cheer Factory, LLC, their owners, officers, agents, coaches, and/or employees, contractors, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
Consent
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT
Participant's Name
(Required)
Participant's Date Of Birth
(Required)
MM slash DD slash YYYY
Participant's Age
(Required)
Name Of Parent/Legal Guardian
(Required)
First
Last
Parent's Email
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Cell Phone
(Required)
Home/Alternate Phone
(Required)
Medical Conditions, Prior Injuries, and/or Allergies
(Required)
Name Of Primary Physician
(Required)
Physician Phone
(Required)
Consent
(Required)
I AGREE TO THE RELEASE OF LIABILITY AND ASSUMPTION OF RISK
This is to certify that I, as parent/guardian with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of the activity and his/her responsibilities for adhering to the rules and regulations. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s/ward’s involvement or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
Today's Date
(Required)
MM slash DD slash YYYY
Name Of Parent/Guardian Signing
(Required)
First
Last
Relation to the Minor
(Required)
Signature
(Required)
Please Complete The Adult Waiver Below
WAIVER AND RELEASE OF LIABILITY AND CONSENT TO MEDICAL SERVICES
In consideration of being allowed to participate in any program, class, team event, tryout, gym/mat rental etc. at Funkytown Cheer Factory, LLC, including any related events and activities, the undersigned acknowledges, appreciates, and agrees that: I hereby consent to myself and all family members participating (including those not listed below) in Funkytown Cheer Factory's program(s). I recognize that potentially severe injuries can occur in any activity involving height or motion, including tumbling and related activities including cheerleading, tumble tramp, trampoline, stunting, pyramids, dance, gymnastics, martial arts, playing on inflatables/bounce houses and physical activity in general. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID19) from the activities involved in this program are significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and, I am aware that coaching cheerleading, tumbling, etc. requires the coach to physically touch me. Whether it is demonstrating a technique, spotting, or catching a falling athlete, I understand that coaches are often required to engage in physical touch in order to adequately do their job In the event of an emergency, I understand that delays in contact medical services can lead to potential risk. Therefore, I authorize Funkytown Cheer Factory, LLC to contact medical services on my behalf to ensure the fastest medical attention possible. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Funkytown Cheer Factory, LLC, their owners, officers, agents, coaches, and/or employees, contractors, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
Consent
(Required)
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT
Participant's Name
(Required)
Participant's Date Of Birth
(Required)
MM slash DD slash YYYY
Participant's Age
(Required)
Email
(Required)
Address
(Required)
Street Address
City
State
ZIP / Postal Code
Cell Phone
(Required)
Medical Conditions, Prior Injuries, and/or Allergies
(Required)
Name Of Primary Physician
(Required)
Physician Phone
(Required)
Today's Date
(Required)
MM slash DD slash YYYY
Name Of Participant Signing
(Required)
First
Last
Signature
(Required)
