California Gymnastics

444 W. Katella Ave, Orange, CA 92867 (714)633-6084


Student Name


 Birth date

Parent/Legal Guardian’s Name






In consideration of participating in the California Gymnastics I represent that I understand the nature of the Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event 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 even death, which may be caused by my own actions or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the "releases" named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and responsibility for losses, cost, and damages I incur as a result of my participation in the Activity.                                    


I hereby releases, discharge and covenant not to sue the California Gymnastics, its representative administrators, directors, agents, officers, volunteers and employees, other participants, any 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 or alleged to be caused in whole or in part by the negligence of the "releasees" or otherwise, including negligent rescue operations and further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes claim against any of the Releasees I will indemnify, save and hold harmless each of the Releasees from any loss, liability, damages, or cost, which any may occur as the result of such claim.


I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY, 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, notwithstanding, shall continue in full force and effect.


Further, I herby give permission for certified and licensed medical personnel to use appropriate procedures to aid myself and or my child to prevent further injury and / or death. If possible, I give permission to the emergency care physicians, support personnel and California Gymnastics to do what they deem necessary in the best interest of my child.


Parent/Legal Guardian’s Signature ___________________________________________ Date _____________


Occasionally the gym passes out treats such as popsicles, etc.  If you would not like your child to receive these treats, you need to be present during the last few minutes of class.  This will allow you to let the instructor know your child will not be having a treat.  THIS IS EXTREMELY IMPORTANT IF YOUR CHILD HAS ANY ALLERGIES OR FOOD RESTRICTIONS.  It is the parent’s responsibility to prevent their child from receiving treats that conflict with their allergies.                                                                                                                       

Initial ______________


I have read and received the California Gymnastics make-up class and policy page and am agreeing to adhere to the policies listed therein.