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Too Busy to Browse
Get the Season 5 Packet
Menu
Programs
Cheerleading
Dance Fundamentals
Dance
Tumbling
Level Up Academy
Flyer Flex
Private Lessons
Daytime Playtime
Upcoming Events
Birthday Parties
Helpful Links
Parent Portal
Waiver
Job Postings
Blog
New Member Special
NEW MEMBER SPECIAL
Waiver
Waiver
WAIVER
Waiver and Release of Liability and Hold Harmless Agreement
"
*
" indicates required fields
Parent or Guardian Name
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First
Last
Phone
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Email
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Participant's Name
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First
Last
Participant's Date of Birth
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MM slash DD slash YYYY
Participant's Age
*
Emergency Contact Name
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First
Last
Emergency Contact Phone
*
Reason for Completing Our Waiver
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Cheerleading
Dance
Tumbling
Events
Parent Consent to Participate
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I agree to the participation waiver.
I, the undersigned parent or legal guardian, give permission for my child to participate in all programs and activities operated by Jasper Jewels LLC, including but not limited to classes, practices, open gyms, camps, clinics, birthday parties, events, showcases, and any related or hosted activities, whether on or off the premises.
I authorize Jasper Jewels LLC, its owners, coaches, staff, employees, contractors, and volunteers to consent to emergency medical treatment for my child if I cannot be reached. I understand that reasonable efforts will be made to contact me and that I am financially responsible for all related medical expenses.
I understand that participation in athletic and recreational activities—including cheerleading, tumbling, dance, gymnastics, and related activities—involves inherent risks, including falls, collisions, physical contact, activities involving height or motion, equipment use, and overexertion, which may result in serious injury, illness, permanent disability, paralysis, or death.
I knowingly and voluntarily assume all risks associated with my child’s participation, whether known or unknown, foreseeable or unforeseeable.
In consideration of participation, I release, waive, and hold harmless Jasper Jewels LLC, its owners, officers, employees, coaches, volunteers, and affiliates from any and all claims or liabilities arising from participation, including those resulting from negligence, to the fullest extent permitted by law.
I acknowledge that Jasper Jewels LLC follows safety procedures and guidelines, but cannot eliminate all risk or guarantee safety. I agree to review and follow all gym rules, policies, and safety guidelines and affirm that my child is physically able to participate or that any medical conditions have been disclosed in writing.
Media Release and Consent
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I agree to the Media Release and Consent
I grant Jasper Jewels LLC permission to photograph, record, and use images, video, and audio of my child taken during classes, practices, camps, clinics, birthday parties, events, showcases, or other gym activities for promotional, marketing, educational, and social media purposes.
I understand that these materials may be used in print, digital, and online formats without compensation and that all content remains the property of Jasper Jewels LLC. I release Jasper Jewels LLC from any claims related to the use of such media.
Signature
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