Athletes Name *

First

Last

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mothers Name *

Cell Phone

Fathers Name *

Cell Phone

Cell Phone Service Provider

Email *

I Consent

I hereby grant consent and authorize the use of photographs, slides, videotapes and film of my child to participating in Burlo Gymnastics activities for commercial and art purposes in any medium of advertising, communication or publicity that will promote Burlo Gymnastics programs, and /or recognition of participants.

Signature *

Date

Gym Waiver

Waiver of Liability & Assumption of Risk

Gym Waiver *

I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF THE ACTIVITY AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I recognize that potentially severe injuries, including permanent paralysis or death can occur in sports or activities involving height or motion, including, but not limited to gymnastics, tumbling and ball sports. Being fully aware of these dangers, I voluntarily consent to the aforementioned person participating in any and all Burlo Gymnastics gym activities and I ACCEPT ALL RISKS associated with that participation. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE AND FOREVER RELEASE BURLO GYMNASTICS, IT’S OFFICERS, DIRECTORS, SHAREHOLDRES, EMPLOYEES OR AGENTS, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE’S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED, OR ALLEGED TO BE CAUSED, IN WHOLE OR IN PART BY NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR’S BEHALF MAKES A CLAIMS AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR ANY COST THAT MAY OCCUR AS A RESULT OF ANY SUCH CLAIM. I have read and understood this ASSUMPTION OF RISK and WAIVER OF LIABILITY and VOLUNTARILY affix my name in agreement.

Waiver of Liability & Assumption of Risk

Signature

Emergency Contact Number

Welcome to Burlo Gymnastics!

We are delighted for the opportunity to work with your children. We have implemented several Policies and Procedures to assure that the training is productive with minimal interruptions.

Club Rules *

No child is permitted to attend class until parents/guardian fills out our enrollment form. The form includes a liability waiver that is standard for athletic clubs and essential to our business.

Dress Code *

Black leotard, black stretchy shorts, and white socks. Gymnasts must keep their hair off the face into a short ponytail or a bun. No jewelry allowed, except small stud earrings. Gymnasts are allowed to wear warm jackets for warm-up time only.

Drop Off & Pick Up *

We insist that parents/guardians physically come into the facility to drop off and pick up their children regardless of age. Classes begin and are dismissed promptly at their scheduled times. Please be sure you physically see your child in class prior to leaving the facility and is pick up on time. As a USAG member club we have to abide by “Safe Sport” rule. We are unable to supervise children prior or post class time. Burlo Gymnastics staff is responsible for children only during their scheduled class time. Gymnasts are allowed to be in the gym early by coach’s invitation only. If you need to pull your child out of practice early, please let the office know at the time of drop-off. In the event of emergency circumstances, please speak to the office staff to assist you in getting your child out of practice.

Attendance *

Gymnasts must remember number 1 rule for the Club when it comes to practices and competitions: EARLY IS ON TIME, ON TIME IS LATE, AND LATE IS TOTALLY UNACCEPTABLE. Please make sure your child is at the gym 15 minutes prior to start of practice. Coming to practice exactly on time and then taking 15 minutes to change is not considered being on time.

Viewing *

Only gymnasts may enter the gym. For safety reasons No parents, grandparents or siblings allowed to enter gym at any time. We provide ample sitting/viewing space in designated area.
*Parents, we are asking that you keep vigilant watch on siblings and young visitors that accompany you when you drop off/pick up your gymnast. Use of any rhythmic equipment from locker room, opening displays and performing gymnastics skills in the hallways is dangerous and not permitted. If you need to speak with your child’s coach, please do so after class. The coach will inform the parent if a behavioral situation requires attention.

Code of Conduct *

Your children are our priority and we at Burlo Gymnastics always have their best interest at heart. The coach holds primary responsibility for maintaining good order at practice and competitions. Gymnast(s) may be asked to leave practice after two prior warnings “for cause” or disciplinary reasons. This may include crying, disruptive behavior, being rude or disrespectful to the coach or teammates.

Missed Practices *

Parents must notify gym via phone call (818) 280-6255 or e-mail (burlogymnastics@yahoo.com) that gymnasts will miss practice prior to practice time (no during or after). If it is an illness, please notify the office and do not come to practice sick! Homework is not an excuse to miss practice. We understand that gymnasts are student-athletes but they need to learn to manage their time in order to continue to be successful students and athletes.

Concerns *

We are asking parents not to call coaches during practice time. Coaches come out to the common area after each class and will answer your questions. If a family member is unhappy with the results of a competition they must wait 48 hours after the competition to address the coach. After 48 hours, gymnast and parent should both talk to the coach. We do care about the success of all athletes and will do everything possible to accomplish that. Every effort will be made to listen to and understand the concerns of the athlete. The athlete may not like the reply, but each concern will be addressed and explanation will be shared with athlete. Parents calling coach every week is unacceptable. The coach reserves the right to end a parent constantly calling them and only discuss matters with the athlete. Harassing or threatening a coach in any way is cause for immediate dismissal from the club.

Parents Responsibilities *

Please make sure that all contact information is current and up to date and all payments are made on time! Please be supporting at practice and competitions. Try not to be critical. All gymnasts and coaches are trying their best. No one is going out there to do a bad job. All gymnasts are responsibility of parents. Please keep in mind that at all competitions the gymnast is the responsibility of the parent. Please reinforce manners, behavior and code of conduct expected of Burlo Gymnastics gymnast. Please be an example to your children. Do Not discuss coaches work or other gymnasts in front of your children. You chose our club and we chose our coaches who are the most qualified professionals in the business. They have titles, knowledge and experience working with children. Any discussions about coaches or gymnasts is prohibited in Burlo Gymnastics facility.

Competition Team Policies and Procedures *

• Placement on the competition team is by invitation from the coach only. The coach's assessment of the skill level and age determines level placement. Gymnasts must complete the season and compete at State and Regionals to advance to the next level. • Levels 3, 4, and 5 gymnasts must attend classes 3 times a week, and take ballet classes. Gymnasts must meet our requirements to compete. • All gymnasts level 6 and up must attend practice 4 times a week or more, and take ballet classes. Gymnasts must meet our requirements to compete. • All competition team members must be respectful of coaches at all times. They also must be willing to accept and follow a coach's corrections. • All team members must be respectful and supportive of their teammates. • Team members must have their own set of equipment and toe-shoes. Gymnasts should also have all apparatus available at every practice. • Routines for level 7 and up are individual for each gymnast. The coaches choreograph routines during private lessons. It is the responsibility of the parents to schedule private lessons. Parents should schedule private lessons during the summer (July and August). Cost of each routine: level 6 $150, level 7-8 $180 and level 9-10 $200. • Set of competition CD’s with club logo is provided to all gymnasts for $10 • Routines for levels 3, 4,5, and 6 are shared by all gymnasts in the same level. The coaches will choreograph routines during regular practice. The cost of all 3 routines for level 3—$75, for level 4—$100, all 4 routines for level 5 and 3 routines for level 6—$150. (Level 6 gymnasts get individual floor routines). • Set of competition CD’s with club logo is provided to all gymnasts for $10 • Routines for levels 3, 4,5 and 6 are shared by all gymnasts in the same level. The coaches will choreograph routines during regular practice. The cost of all 3 routines for level 3—$75, for level 4—$100, all 4 routines for level 5 and 3 routines for level 6—$150. (Level 6 gymnasts get individual floor routines). • Private lessons are available with all coaches and can be scheduled directly with the coach. • All parents are responsible for renewing their annual membership to USA Gymnastics. Your child must have a current membership to compete. (No exceptions!) • The gymnast must follow USAG rules for competition. A gymnast may not proceed to State Competition unless they attend two invitational competitions. A gymnast may not compete at Regionals unless they compete in State Competition. A gymnast may not go to Nationals unless they compete at Regionals. • Levels 3, 4, and 5 can compete in local competitions only but may have to go out of town for State, Regionals and Nationals. Level 6 and up gymnasts will attend local, out-of-town, and out-of-state competitions throughout the competition season. National Qualifier, US Nationals, and Junior Olympics are usually held on East Coast. • The registration fee for any competition is the responsibility of the parents. Registration fees are payable to Burlo Gymnastics. Parents must pay the registration fee at the time of official notice usually given 2-3 months in advance. Registration fees are non-refundable. • Parents are responsible for the coach's competition fees and travel expenses, which include transportation and lodging. Coach's competition fees and travel expenses are due at the time of registration and are not refundable. For all invitational, State and Regional competitions the fees are: Local competition - $75, 0ut of Town competition (San Diego or San Francisco) - $120, 0ut of State competition - $175. For Open Championships, the US National Championship, Junior Olympics, Level 9 Classic, US Challenge, and National Qualifier all expenses are divided equally among participating gymnasts. • Gymnasts should arrive at the competition 2 hours before the start of their rotation. Gymnast's hair must be in a bun, and make-up is done. Gymnasts must dress in a black leotard with the club logo and Burlo Gymnastics warm-ups. Gymnasts should have all equipment, toe shoes, and leotards with them. Gymnasts in Levels 3 and 4 must wear the same leotard for all three routines. Levels 5 and 6 may wear two leotards, and levels 7 and up may wear four. • On arrival, gymnasts should immediately go to the warm-up area and find their coach. The warm-up area is only for gymnasts and coaches. All parents must find seating in the common area. • Parents can not approach other coaches or judges for any reason. If a parent approaches a judge, the gymnast will be immediately disqualified. So, if you have an emergency or a problem, please text or call your coach and let them know. We recognize the commitment required for a competition team because it is time-consuming not only for gymnasts but also for parents. It is also a financial obligation and requires a certain level of commitment. We urge parents to weigh all pros and cons; we will support you in any decision you make.

Gymnast Signature

Parent Signature

Medical Release Form

This must be completed and signed in all areas by both athlete and parents. I understand and agree that his document will be kept in the possession of authorized personnel and that reasonable care will be used to keep this information confidential. By signing this form the participant affirms having read and agreed to terms and conditions listed below:

Athletes Name *

Primary Contact Name *

Primary Contact Phone

Seconday Contact Name *

Secondary Contact Phone

Primary Insurance Company

Group/ Policy #

Family Physician Name *

Physician Phone

Please elaborate on any medical conditions of which we should be aware:

Please list any medications currently being taken:

Please list any allergies:

Checkboxes *

If, during the course of my child’s activities in gymnastics she will become ill or sustain an injury, I hereby authorize you to obtain emergency medical care. I will assume financial responsibility for the bills incurred through my insurance company.
I do not authorize emergency medical care for my child

Parent Signature