Tumble Kids USA

201 Arlington Street, Watertown, MA 02472

Phone....(617) 926-2640     Fax....(617) 926-3440   E-mail.... Tumblekids@aol.com

38 River St., Winchester, MA 01890

Phone....(781) 721-1144     Fax....(781) 721-1164   E-mail.... Tumblekids@aol.com

2007-2008 Registration Form

Registration - Please fill out the form below and return it to Tumble Kids USA. Registration may be done by mail, phone or in person and must include your full class tuition & registration fee. 10% discount for the 2nd and 3rd child in the family (class program only).

Refunds - Refunds will not be given after the start of a session.

What To Wear - Girls should wear a leotard (no skirts) with hair securely tied back. Tights without feet may be worn. Boys should wear gym shorts or sweat pants and a T-shirt. No jeans or jewelry. All students must have bare feet.

Refund Policy - Refunds will not be given after the start of each session.

Student's Name_______________________________Referred by____________________________

Address_____________________________________City_______________Zip_________________

Home Phone(___)_____________E-Mail______________________Age___Date of Birth___/___/___

Parent's Name____________________Parent's Work Phone(___)__________Fax # (___)__________

Parent's Name________________________________Parent's Work Phone(___)_________________

Emergency Contact Name_______________________Phone(___)____________________________

PROGRAM_____________SESSION_____________CLASS DAY_____________TIME___________

2ND CHOICE:  DAY_____________________________TIME________________________________

Tuition $_________________

Registration Fee $__________

Total Enclosed $___________

Payment Method: Check #_________________Credit Card #_________________Exp. Date________

Are there any medical conditions to which we should be alerted?______________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Acknowledgement of Risk and Waiver of Liability

          As a parent or legal guardian of (student's entire name)________________________, I hereby consent to the aforementioned participating in gymnastics and related activities with Tumble Kids USA. I recognize that potentially severe injuries, including permanent paralysis or death can occur in any activity involving height or motion, including dance, gymnastics and other related activities. I understand it is the express intent of Tumble Kids USA to provide for the safety and protection of my child and, in consideration for allowing my child to use these facilities, I hereby forever release Tumble Kids USA, its officers, employees, teachers, and coaches from all liability for any and all damages suffered by my child while under the instruction, supervision, or control of Tumble Kids USA or its employees. As parent or legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of any injury sustained while participating in gymnastics classes at Tumble Kids USA. This acknowledgement of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent.