Online Application

Signifies Required Field
Student's Name
Birthdate

Gender
Address
City
State
Zip

Parent's Names
Email
Home Phone

Mother's Business Phone
Cell Phone Father's Business Phone

Emergency Name Emergency Phone

Any Physical Restrictions?

Session

Class(es) Desired

  Day Time
1st Choice
2nd Choice

Fees

Class Fee $  
Insurance/ Registration $ (Pay once Sept.-June) ($35 first child - $25 each add'l child)
Other Charges or (Credits) $  
Total Fees $  
  Date Paid
  Check#

Release

By the very nature of the activity, gymnastics comes with a risk of physical injury. No matter how careful the gymnast
and the coach are, no matter how many spotters are used, no matter what height is used or what landing surface exists,
the risk cannot be eliminated. Reduced, yes, but never eliminated. The risk of injuries includes minor injuries such as
bruises and more serious injuries such as broken bones, dislocations and muscle pulls. The risk also includes
catastrophic injuries.

Gymnastics, or any activity that involves motion, rotation, and height in a unique environment carries with it a
reasonable assumption of risk. Spotlight Gymnastics is responsible to inform all participants and their parents or
guardians of the risk involved in the activity of gymnastics. Everyone participating in the Spotlight Gymnastics program
must adhere to the safety rules governing the gymnasium.

In consideration of Spotlight Gymnastics acceptance of the applicant(s), and in consideration of the applicant's
opportunity to improve gymnastic skills through the use of Spotlight staff, equipment, and facilities, those legally
responsible for the named enrolling student(s) realize the risk of injury involved and hereby agree to assume the
responsibility of such for said student(s) and further agree to save and hold harmless said school, it's employees, and
all others concerned, and to indemnity them against loss. Intending to be legally bound, our signature is offered hereto:
By signing below I acknowledge the above release and agree to abide by the Rules and Regulations as set forth by
Spotlight Gymnastics.
I accept the above release
Yes
Signature
(Please type your full name)
 
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