RELEASE OF LIABILITYJV management a corporation and its affiliates, Gym Kidz Pembroke Pines LLC, Gym Kidz to go LLC, Gym Kidz North Miami LLC and Gym Kidz LLC("collectively Gym Kidz ") recognizes its obligation to make our students and their parents (or legal Guardians) aware of the risks and hazards associated with the sport of gymnastics, tumbling, cheerleading and dance. Gymnastics, tumbling and cheerleading can be dangerous and may lead to minor or serious injuries. Parents (or legal guardians) should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and coaches' instructions. In case of emergency, I/we understand that my/our child/children will be transported to the nearest hospital by the local emergency resource if rescue squad deems necessary. I/We understand that I/we will be responsible for all medical and emergency transportation expenses. It is understood that in some medical situations, the staff will need to contact the emergency resources before contacting the parent or other adult acting on the parents’ behalf. In exchange for participation in gymnastics, tumbling, dance or cheerleading instruction at Gym Kidz facilities, or in any exhibition or clinic with Gym Kidz , or while traveling to or from an event organized by Gym Kidz , and/or the use of the property, facilities and services of Gym Kidz, I agree for myself and for my child/children to the following:I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Gym Kidz, its employees, representatives or agents.With the above in mind and being fully aware of the risks and possibilities of injuries involved with the above described activity, I consent to have my child/children participate in the programs offered by Gym Kidz and hereby assume full responsibility for personal injury to myself and my child/children, and further release and discharge Gym Kidz for injury, loss or damage arising out of my or my family's use of or presence upon the facilities of Gym Kidz, whether caused by the fault of myself, my family, Gym Kidz or other third parties.I agree to indemnify and defend Gym Kidz and its owners, managers, officers, directors, affiliates and operators against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family's use of or presence upon the Gym Kidz' facilities, including but not limited to any activity involving gymnastics, tumbling, dance or cheerleading instruction, or in the course of any exhibition or clinic or birthday party in which I or my child/children may participate with or on behalf of Gym Kidz or while traveling to or from an event with Gym Kidz.I agree not to bring any type of suit, claim, or complaint, in law, equity, or through an administrative agency, for costs, expenses, principal, interest, fees or otherwise, against Gym Kidz, its owners, officers, directors, employees, agents, subsidiaries or affiliates with respect to gymnastics, tumbling, dance or cheerleading instruction birthday party, clinic or event at the Gym Kidz facilities, or in any exhibition or clinic with Gym Kidz, or while traveling to or from an event with Gym Kidz or any contractual matter between myself and Gym Kidz, its owners, managers, officers, directors, affiliates and operators.As the legal parent or guardian, I hereby release and hold harmless Gym Kidz, its owners, managers, officers, directors, affiliates and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, and/or my child/children, while in or upon the premises or any premises under the control and supervision of Gym Kidz, Inc., its owners, managers, officers, directors, affiliates and operators or when in transit to or from any of said premises.Gym Kidz, its coaches and other staff members shall not be held responsible for injuries sustained by any student during the course of gymnastics, tumbling, dance or cheerleading instruction, or in the course of any exhibition or clinic in which she/he may participate or while traveling to or from an event with Gym Kidz.I also affirm that I now have and will continue to provide proper hospitalization, health and accident insurance coverage which I consider adequate for both my child's protection and my own protection. I also understand that it is my responsibility to warn the child about the dangers of gymnastics and injury.As such, I shall be required to warn the child according to what I feel is appropriate. Gym Kidz, will supplement such warnings through "safety messages", teaching style and progressions.Medical Emergency. I give permission to Gym Kidz, Inc., its owners and operators to seek medical treatment or attention for my child in the event Gym Kidz, Inc. is not able to reach me or my emergency contact, as may be required by the circumstances, including without limitation, that of a licensed medical physician and/or a hospital, as well as the power to authorize medical treatment or medical procedures in an emergency situation.I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health.In the event of an emergency, I request that my doctor/physician called and that my child be transported to our designated hospital. Our Physician's phone number shall be provided to Gym Kidz.Any legal or equitable claim that may arise from participation in the above shall be resolved under Florida law.Venue shall be Miami-Dade County, Florida. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if desired.I acknowledge that Gym Kidz has offered to refund any fees that have been paid by me to use its facilities if I choose not to sign this Agreement.This Agreement and each of its terms are the product of an arms' length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement, or any of its provisions, the Parties, and each of them, explicitly reject the application of any legal or equitable rule of interpretation which would lead to a construction either "for" or "against" a particular party based upon their status as the drafter of a specific term, language, or provision giving rise to such ambiguity.The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.Any controversy or claim arising out of or relating to this contract, or the breach thereof, shall be settled by arbitration in Miami-Dade County and administered by the American Arbitration Association in accordance with its Commercial Arbitration Rules, and judgment on the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof.In case of an emergency, please call me and/or the emergency contact that has been provided to Gym Kidz.Concussion Protocols:Gym Kidz is committed to protecting the health of and providing a safe environment for each of its participating athletes. We recognize that gymnastics is a high-risk sport for concussion. To this end, Gym Kidz has adopted the following Concussion Safety Protocol for all athletes. This protocol identifies expectations for the club’s concussion management practices as they relate to (1) the definition of sport-related concussion; (2) preseason education; (3) recognition and diagnosis; (4) post-concussion management; (5) return-to-learn & sport; and (6) limiting exposure to head trauma. Definition of Sport-Related ConcussionThe Consensus Statement on Concussion in Sport, which resulted from the 5th international conference on concussion in sport, defines sport-related concussion as follows:Sport-related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. Several common features that may be utilized to clinically define the nature of a concussion head injury include:SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms evolve over a number of minutes to hours.SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged.Preseason EducationAll athletes and parents of minor athletes will be provided and allowed an opportunity to discuss educational material (e.g., the USA Gymnastics Sports Concussion Overview) and be required to sign an acknowledgement, on an annual basis and prior to participation, that they have been provided, reviewed and understood the concussion education material. All coaches involved in athlete health and safety decision making are required to complete concussion education training prior to coaching and annually thereafter. Coaches must be allowed an opportunity to discuss educational material (e.g., the USA Gymnastics Sports Concussion Guidelines, the USA Gymnastics Sports Concussion Overview) and be required to sign an acknowledgement, on an annual basis, that they have been provided, reviewed and understood the concussion education material.Concussion education should include:The definition of concussion Possible mechanisms of injury Common signs and symptoms Steps that can be taken to prevent concussions and other injuries from occurring in gymnasticsWhat to do when an athlete has suffered a suspected concussion or more serious head injury What measures should be taken to ensure proper medical assessment Return-to-School and Return-to-Sport Strategies (See USAG return to sport progression for gymnastics-specific progressions for each discipline)Return to sport medical clearance requirements Recognition and Diagnosis of ConcussionAll coaches in a member club must be able to recognize the potential mechanism of injury of a concussion and the signs and symptoms of acute concussion. Coaches must immediately discontinue training or competition for anyone who is suspected of having a concussion and must monitor the athlete until a parent arrives. Coaches must be able to recognize red flag signs and symptoms and must activate 911 if these signs and symptoms are present.Medical personnel with training in the diagnosis, treatment and initial management of acute concussion will be present at all high-risk USAG sanctioned competitions (see Rules & Procedures for definition of high-risk for your discipline).Any athlete that exhibits signs, symptoms or behaviors consistent with concussion:Must be removed from practice or competition until they are evaluated by a medical professional.Must be evaluated by a physician (or physician designee) with concussion experience.May only return to play the same day if onsite medical personnel determine that concussion is no longer suspected.Post-concussion ManagementActivation of emergency action plan must occur for any of the following scenarios following a suspected concussion:Severe or worsening headacheWeakness or numbness in the arms or legsVomitingSlurred speechNeck painDouble visionSeizure activity or convulsionsAgitated or combativeLoss of consciousness or deteriorating conscious state (going in and out of consciousness)Because concussion may evolve or manifest over time, for all suspected or diagnosed concussions, athlete should be monitored by club personnel trained in concussion until a parent arrives. An athlete should never be allowed to drive him/herself home after a suspected concussion. For all cases of suspected or diagnosed concussion, there must be documentation that post-concussion plan of care was communicated to both the athlete and another adult responsible for the athlete, using the USA Gymnastics Sports Concussion Information form.Return-to-Learn & SportPrior to return to gymnastics after a concussion event, the athlete must be symptom free with all activities of daily living and academic activities. Performance of academic activities must be back to the athlete’s baseline and without modification.Return-to-sport progressions should not begin until the athlete has completed an unrestricted return-to-learn progression. Initiation of the return-to-sport protocol must be approved by a physician or his/her medically qualified designee.The timeline for return-to-sport varies based on individuals and other medical conditions including prior history of concussion. It generally takes longer for children and adolescents to return-to-sport than it does for adults.Final determination of unrestricted return-to-sport will be made by a physician or his/her medically qualified designee following implementation of an individualized, supervised stepwise return-to-sport progression detailed in the USA Gymnastics Gymnastics-Specific Return-to-Sport Strategy document that includes: Rest followed by light aerobic activity.Return to early sport training: Inversion.Progress sport specific training: Flipping.Progress sport specific training: Twisting.Progress sport specific training: Advanced Skills (physician clearance required to move to step 6).Return to full training.The above stepwise progression will be supervised by a health care provider with expertise in concussion, with it being typical for each step in the progression to last at least 24 hours.NOTE: If at any point the athlete experiences a return of concussion-related symptoms, they should go back to the previous stage that they completed symptom-free, wait for symptoms to resolve (minimum 24 hours), and then begin the progression again. The minor athlete’s parent should always be notified if the athlete becomes symptomatic.Limiting Exposure to Head TraumaGym Kidz is committed to protecting the health of and providing a safe environment for each of its participating athletes. We will provide a safe environment for our athletes by:Ensuring gymnasts have completed proper progressions prior to trying a new skill.Using proper mats and equipment setup.Having spotters in place at practice and during competition.Ensuring the area is clear prior to beginning a skill to prevent collisions.Ensuring equipment is properly maintained and inspected. I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY AGREEING TO THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS. READ CAREFULLY - THIS AFFECTS YOUR LEGAL RIGHTS
Media Release Form for Parent and Child
I hereby certify that I am the parent and/or guardian of the minor child under eighteen years of age, and I hereby grant full and irrevocable consent to Gym Kidz, Inc and Gym Kidz NM LLC., its successors and assigns and those acting under its permission to reproduce, copyright, publish, circulate or otherwise use my name, the minor child's name, and/or photographic likenesses of me and/or the child named on this registration form as single, multiple, or moving images in which I or the minor child may be included in whole or in part, or composite. I waive any right to inspect and approve the finished product or copy that may be used or the use to which it may be applied.
This authorization and release covers the use of said materials in any published, broadcast, or electronic form, and in any medium of advertising, publicity, or trade in any part of the world in perpetuity. I understand that pictures and video footage of me and/or my child, as well as other members of my family, may be posted/displayed, viewed in group meetings, and printed in agency newsletters. I understand that these pictures may be used in other media outlets, such as newspapers or magazines or social media handles.
Furthermore, I for myself, my heirs, executors, administrators, or assigns, transfer to the organization, its successors and assigns, all my rights, title, and interest in and to such materials to Gym Kidz, Inc., Gym Kidz North Miami Inc. its successors and assigns.
This agreement represents in full all terms and considerations with respect to the subject matter hereof, and no other inducements, statements, or promises have been made to me. These images will be used for Gym Kidz and Gym Kidz North Miami Inc purposes only, and will not be given or sold to outside companies or individuals.