Sibling Discount: $
Total Amount Due: $
Payment: Please select one
I authorize Azarian Gymnastics or its authorized agent to consent to any medical treatment and/or hospital, which is
given to the child, listed on this form,under the supervision of a duly licensed physician or trained medical
personnel. Also, unless otherwise stated, I understand that my child will be participating in a gymnastics related
activity at Azarian Gymnastics. I understand that as with all physical activities, there is a chance for injury. I
therefore hold Azarian Gymnastics; its employees and its officers harmless should any injury occur. Azarian US Gymnastics, Inc.
does not provide care and well-being and will respectfully decline to complete your FSA form requesting out tax ID,
nor will it provide a filled out W-10 upon request.
I give permission for my child to walk across Glenwood St. from Azarian Gymnastics to the Glenwood Aquatic Center with Azarian camp counselors, and to participate in all swimming activities. I understand that there will be certified lifeguards in attendance at all times. In the event of an emergency, I authorize medical treatment by Azarian Staff, Glenwood Aquatic Center Staff, and any responding emergency personnel.
I agree to allow Azarian Gymnastics to use photographs including the above named minor to be used for marketing purposes.