Trial DateContact InformationMom's NameMom's PhoneDad's NameDad's PhoneGuardianGuardian's PhoneStreet Address *Apartment, suite, etcCity *State/Province *ZIP / Postal CodeCountry AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweHome Phone *Email Address *How did you hear about us?Student's InformationName *Date of Birth *Age *Class Name *Class Day and Time *Medical Conditions or Allergies Your Child May HaveMy child has a medical condition or allergy *YesNoIf yes, please explain medical condition/allergies:Waive of LiabilityHTMLIn consideration of allowing the previously declared participants to begin participation in Quest Gymnastics & Extreme Sports Center programs and/or activities, while on the premises and properties of Quest Gymnastics & Extreme Sports Center, the undersigned, relatives, friends, or their agents for release will hold harmless GE Gymnastics , it’s owners, officers, employees, and agents, of and from any and all liability, claims, demands, and causes of action whatsoever, rising out of, or relating to, any loss, damage, injury, including death, that may be sustained by the participant(s), relatives, friends, agents an/or the undersigned, while in or upon the premises of Quest Gymnastics & Extreme Sports Center is conducted, or any premise under control and/ or the supervision of Quest Gymnastics & Extreme Sports Center owners, officers, employees, and agents, or in route to or from any of said programs or activities sponsored by or participated in by Quest Gymnastics & Extreme Sports Center, it’s owners, officers, employees, or agents. InitialsStart signing your signature hereYour browser does not support e-Signature field.In consideration of participation in Gymnastics/Extreme Ninja/Dance/Parkour, I represent that I understand the nature of this Activity and that I/my child is qualified, in good health, and in proper physical condition to participate in such activity. I acknowledge that if I believe conditions are unsafe, I will immediately discontinue participation in the activity. I fully understand that this activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participation in the event, the conditions in which the event takes place, or the negligence of the “releases” named below. I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my (child) participation in the activity. I hereby release, discharge, and covenant not to Quest Gymnastics & Extreme Sports Center/ Extreme Ninja/Parkour/Dance, its respective administrators, directors, agents, officers, volunteers, employees, other participants, sponsors, advertisers and, if applicable, owners and lessors of premises on which the activity takes place (each considered one of the RELEASEES herein), from all liability, claims, demands, losses, or damages on my account caused in whole or in part by the negligence of the “releases” or otherwise, including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releases, I will indemnify, save, and hold harmless each of the Releases from any loss, liability, damage, or cost, which any may incur as the result of such claim. Any and all gymnastics/Parkour/ Extreme Ninja skills will be conducted in a safe gym environment and will not hold Quest Gymnastics & Extreme Sports Center/ Extreme Ninja/Parkour harmless of any injuries incurred in and outside gym area. *InitialsStart signing your signature hereYour browser does not support e-Signature field.Assumption of Risk: Participants in physical activities can involve motion, rotation, and height in a unique environment and as such carries with it a certain assumption of risk. The undersigned, their relatives, friends, agents, and the participant(s) choose to voluntarily enter upon said premises under the control of said corporation, knowing their present condition and knowing that said condition may become more hazardous and dangerous during the time the participant(s) or the undersigned, their relatives, friends, and agents is on said premises. The undersigned, participant(s), all relatives, friends,and agents voluntarily assume and all risks of loss, damage, injury, or death that may be sustained by the participant(s), the undersigned or any other property owner by them while on the premises of Quest Gymnastics & Extreme Sports Center. The said premises may but is not obligated to carry insurance on the participant(s), and the existence of insurance shall not charge, alter, or increase the liability of the corporation to the participant, their relatives, friends, and agents of affect the terms of this release. In signing this release the undersigned has and agreed: They he/she has thoroughly read and understands completely the terms of the Registration and Release and voluntarily signs it. Also, that he/she is the true parent or Legal Guardian and has the consent of the participant. InitialsStart signing your signature hereYour browser does not support e-Signature field.Medical Release-Conditions-Allergies: The undersigned gives permission for Quest Gymnastics & Extreme Sports Center owners. Officers, employees, and/or agents, to seek emergency medical treatment for participant(s) in the event that they are unable to reach the parent or guardian. The undersigned also agrees that they are themselves and will be responsible for any financial debt incurred by said action. It is the policy of Quest Gymnastics & Extreme Sports Center to request transport to the closest Children’s Hospital, unless a written note with specific alternate instructions is attached to this form. InitialsStart signing your signature hereYour browser does not support e-Signature field.I have read the Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, not withstanding, shall continue in full force and effect. *Parent/ Legal Guardian SignatureStart signing your signature hereYour browser does not support e-Signature field.DateSend MessagePlease do not fill in this field.