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Too Busy to Browse
Menu
Programs
Cheerleading
Tumbling
Private Lessons
Events
Birthday Parties
Upcoming Events
Summer Camps
Helpful Links
Parent Portal
Waiver
Gym Rentals & Choreography
Our Staff
Blog
Job Postings
Absence Request Form
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Waiver
Waiver
WAIVER
Waiver and Release of Liability and Hold Harmless Agreement
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Is the participant at least 18 years of age?
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Yes
No
Parent or Guardian Name
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First
Last
Phone
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Email
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Consent
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I consent to receiving information, news, and discounts by e-mail.
Participant's Name
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First
Last
Participant's Date of Birth
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MM slash DD slash YYYY
Minor's Signature
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Treatment/Publicity/Liability Release
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I agree to the Treatment/Publicity/Liability Release
I authorize any licensed physician to render necessary emergency treatment for injury or serious illness when a parent cannot be reached. I will assume all financial responsibility for such treatment. I acknowledge that the above participant must have his/her own medical insurance. I understand that cheerleading camp, competitions, practices, clinics and gymnastics equipment have an inherent danger in participation, in spite of all precautions and accident preventatives, injuries do occur. I also acknowledge that each participant has elected to participate in Rebels Elite at their own risk and will not hold Rebels Elite employees and/or instructors liable for any and all injuries that may occur while participating in cheerleading. The undersigned does hereby grant Rebels Elite and its successors, the unrestricted right to use the undersigned's name, likeness or appearance on any cheerleading or dance camp posters, calendars, photo content or medium to promote or market Rebels Elite. The undersigned does hereby expressly release and waive any demand, action, claim, license, royalty or other form of payment the undersigned and his or her agents, representatives or assigns may have based on claims of the undersigned as to rights of privacy, publicity, notoriety or any other rights arising out of relating to any use of Rebels Elite of the undersigned's name, likeness or appearance.
Medical Release Waiver
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I agree to the Medical Release Waiver
I certify that I am the parent or legal guardian for my child(ren). I hereby give my permission for any supervisor, coach or other team administrator associated with the Rebel Elite SF to seek and give appropriate medical attention for our Child(ren) in the event of an accident, injury, illness. I will be responsible for any and all costs associated with any necessary medical attention and/or treatment. I hereby waive, release and forever discharge Rebels Elite SF from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in Rebel Elite SF activities, whether or not damages or loss is due to negligence. I hereby acknowledge that my children is (are) physically fit and capable of participation in al activities.
Electronic Signature Consent
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I agree
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
Parent or Guardian's Signature
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