509-533-9646 
www.spokanegymnastics.com 
5615 E. Broadway Avenue Spokane, Washington 99212 


In consideration of being allowed to enter the gymnastics area and/or participate in any activity at 
Spokane Gymnastics, the undersigned, on his or her behalf, and on the behalf of the participant(s) 
identified below, acknowledges and agrees to the following conditions. 

I acknowledge that I am the parent or legal guardian of the child(ren) identified below and voluntarily 
authorize my child to participate in gymnastics activities at Spokane Gymnastics. I understand that 
there are inherit dangers associated with gymnastics and recognize that any physical activity involves 
risks of serious injury or death, including but not limited to temporary or permanent muscular and 
skeletal injury and paralysis. Knowing these risks, I and my child(ren) assume all risks, whether 
foreseen or unforeseen, in connection with my child participation in this activity. 

WE AGREE TO DEFEND, INDEMNIFY, HOLD HARMLESS, WAIVE, AND RELEASE THE 
SPOKANE GYMNASTICS, TOGETHER WITH ITS OFFICERS, TRUSTEES, EMPLOYEES, 
AGENTS AND MEMBERS, AGAINST ANY AND ALL LIABILITY, CLAIMS AND CAUSES OF 
ACTION ARISING OUT OF, OR IN ANY WAY CONNECTED WITH MY CHILD'S 
PARTICIPATION IN THIS ACTIVITY. 

Participant's Name:________________________________________ Date of Birth:_______________ 

Parent/Legal Guardian Signature:________________________________________________________ 

Parent Name (Please Print):____________________________________________________________ 

Mailing Address:_____________________________________________________________________ 

____________________________________________Zip:___________________________________ 

Phone:____________________________________________ 

Participant's Name:________________________________________ Date of Birth:_______________ 
Parent/Legal Guardian Signature:________________________________________________________ 
Parent Name (Please Print):____________________________________________________________ 
Mailing Address:_____________________________________________________________________ 
____________________________________________Zip:___________________________________ 
Phone:____________________________________________