Name: _____________________________________________________ Age: ____________________
Parent Name: __________________________________________________________________________
Phone: ______________________________________ Email: __________________________________
How did you hear about THR!VE? ____________________________________________________
Method of Payment: Cash______ Check ______ Credit Card _______ No Charge _______
Participant Emergency Contact Number: ____________________________________________
Liability Release: I understand that my participation in any THR!VE LLC (Dance, Cheer, Tumble, Camp, Workshop, Birthday Party) activity, may result in injury. I acknowledge and understand that injuries are common among dance, cheer & tumble related events and that I am assuming the risk of such injury by participating in any activities at THR!VE LLC. In the event of injury, I authorize THR!VE LLC Staff to obtain necessary medical treatment on my behalf. I understand that THR!VE LLC, the host studio and/or it’s directors, officers, owners, employees, teachers, assistants, staff, crew, etc. are not liable for personal illness, personal injury, damage or loss to personal property. I understand that I will be responsible for any and all medical and related bills and claims that may be incurred for any illness or injury that I may sustain during a THR!VE LLC activity. I also understand I may decline to participate in any class or any activity.
Appearance Agreement: I understand that as a participant in and/or a spectator at THR!VE LLC activity, I may be included in videotapes or photographs taken during the event. I agree to be photographed and/or videotaped and that my name, face, likeness voice, and appearance may be used in advertising and promoting THR!VE LLC.
Signature (minor participant):___________________________________________Date:_____________
Parent or legal Guardian (print):____________________________________________________________
Parent or legal Guardian signature: _____________________________________Date:_____________