Waiver

This waiver form is required to be signed by a parent or guardian before a child will be allowed to participate in activities at our facility. It is to be signed in the office in person, before or on your child’s first day of class or before the start of a special event like Open Gym or Birthday Parties. All participating individuals absolutely must have a waiver on file before they will be allowed to participate. NO EXCEPTIONS. If completing a hard copy of the waiver, please do not bring in a printed and previously signed form, as we will require you to sign a different copy in person upon arrival.

A printable copy of the waiver is available here.

Waiver/Liability Release Form 

Note, this version is for reading and documentation purposes only, as such this copy is not intended to be printed or signed.

I, as the undersigned parent and/or guardian, certify that by registering my child with Dmitri Poliaroush, individually, and doing business as Trampoline and Tumbling Express ("Trampoline and Tumbling Express"), that I am aware of all the inherent risks associated with participation in and practicing for gymnastics, sports, acrobatics, tumbling and other exercises engaged in participants in Trampoline and Tumbling Express. I, and my child understand that participation in gymnastics practice and competition with Trampoline and Tumbling Express is entirely our choice and it is with this understanding of risk of accidental injury involved in any activity involving unusual motion or height, that I have given my full consent for my child to take part in these sports activities with Trampoline and Tumbling Express. I certify that I have contacted my child's physician about his/her participation in this program and that the physician has examined my child and has endorsed my child's participation in the program. With this release form I also certify that any medical expenses, should an accident occur, are covered by my insurance policy or will otherwise be borne by me personally. I also authorize a licensed hospital or licensed health care practitioner to perform an examination or render any emergency treatment which may be necessary in the event my child is injured during his/her participation in Trampoline and Tumbling Express activities if I am not present to direct the course of my child's treatment.

In consideration of my child being allowed to participate in Trampoline and Tumbling Express' program, I hereby, for my child, personally assume all risks in connection Trampoline and Tumbling Express' gymnastics program and I further release Dmitri Poliaroush, individually, and doing business as Trampoline and Tumbling Express, its successors, employees, and agents, from any and all liability for any injury or damage which may occur as a result of my child's participation in Trampoline and Tumbling Express' program, including all risks connected therewith, whether foreseen or unforeseen; and further, to save and hold harmless Dmitri Poliaroush, individually, and doing business as Trampoline and Tumbling Express, its officers, employees, directors and agents from any claim by me individually, or on behalf of my child, his/her family, estate, heirs or assigns arising out of his/her enrollment and participation in Dmitri Poliaroush, individually, and doing business as Trampoline and Tumbling Express.

I have fully informed myself of the contents of this release agreement by reading it before signing it. I agree that no oral representations, statements or inducements, apart from the foregoing written release agreement, have been made. I agree that the foregoing release agreement and waiver are intended to be as board and inclusive as permitted by the laws of the State of Louisiana, and that if any portion thereof is held invalid, it is agreed that the balance shall notwithstanding, continue in full force and effect.

IN WITNESS THEREOF, I have executed this consent, waiver and release agreement electronically on the day this has been submitted.