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TATIANA GUTSU GYMNASTICS ACADEMY

TRIAL CLASS PARTICIPATION & LIABILITY WAIVER

Welcome to Tatiana Gutsu Gymnastics Academy!

We're excited to introduce your child to the wonderful world of gymnastics!

Before participating in a trial class, a parent or legal guardian must complete this form.

1. STUDENT INFORMATION

Student's Full Name

Student's Date of Birth

Parent / Guardian Full Name

Parent / Guardian Phone Number

Parent / Guardian Email

Trial Class Date

Trial Class Name / Level

2. HEALTH & EMERGENCY INFORMATION

Does your child have any medical conditions, allergies, previous injuries, concussions, or physical limitations that may affect participation?

A
B

Emergency Contact Name

Emergency Contact Phone Number

3. ASSUMPTION OF RISK & LIABILITY ACKNOWLEDGMENT

I understand that gymnastics is a physical sport involving strength, flexibility, balance, coordination, jumping, tumbling, and the use of gymnastics equipment.

I acknowledge that participation may involve inherent risks, including but not limited to falls, collisions, muscle strains, sprains, fractures, concussions, head injuries, and other serious injuries.

I understand that TGGA coaches will provide instruction and safety guidance; however, no physical activity can be guaranteed to be completely risk-free.

I voluntarily authorize my child to participate in the scheduled trial gymnastics class and acknowledge the inherent risks involved.

To the fullest extent permitted by applicable Michigan law, I agree to release TGGA, its owners, employees, coaches, and representatives from claims arising solely from the inherent risks of the trial gymnastics activities. This provision does not release any party from liability that cannot legally be waived.

I have read and understand the risks associated with gymnastics participation and the liability acknowledgment.

4. CONCUSSION & HEAD INJURY ACKNOWLEDGMENT

I understand that gymnastics participation carries a risk of concussion and other head injuries.

I understand that a concussion can occur even without loss of consciousness and that symptoms may develop after the injury.

I acknowledge that:
• My child must stop physical activity immediately if a concussion is suspected.
• TGGA may remove my child from the class due to a suspected concussion.
• My child must not resume participation until the applicable medical clearance requirements have been met.
• I am responsible for informing TGGA about any known recent concussion or medical restrictions affecting my child's participation.

I acknowledge that I have received and reviewed the concussion awareness information provided by TGGA.

5. EMERGENCY MEDICAL AUTHORIZATION

In the event of an injury or medical emergency, I authorize TGGA staff to contact emergency medical services and arrange emergency assistance if I cannot be reached promptly.

I understand that I am responsible for applicable medical expenses.

I agree to the emergency medical authorization.

6. CLASS PARTICIPATION & SAFETY

I understand that:
• My child must follow the instructions of TGGA coaches.
• My child may only use gymnastics equipment when authorized by a coach.
• TGGA may discontinue participation when necessary for safety.
• Completing a trial class does not guarantee enrollment or placement in a particular gymnastics program.

I understand and agree to TGGA's safety and participation requirements.

7. PARENT / GUARDIAN CONSENT

I certify that I am the parent or legal guardian of the student listed above.

I have read and understand the risks, acknowledgments, and authorizations contained in this form.

I voluntarily authorize my child to participate in the scheduled gymnastics trial class.

Parent / Guardian Electronic Signature

Sign here

Date

Trial Class Payment
Please complete your payment before submitting by visiting our payment portal.
Tatiana Gutsu Gymnastics Academy
24723 Crestview
Farmington Hills, MI 48335

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