Date

MM

DD

YYYY

to take part in Flip&Twist classes, routines, and exercises operated by Flip&Twist and its owners, employees, representatives and/or affiliates. *

I have read and agree to the above clause.

I am aware that participation in the classes, routines, and exercises will require me to engage in many vigorous physical activities. I am voluntarily participating in these activities with the knowledge that there are possible risks involved including serious injury and even death. I hereby assume all risks and hazards incidental to such participation and agree to accept any and all risks of injury and/or death as a result of my participation in these routines and exercises. *

I have read and agree to the above clause.

I am aware that the routines, exercises, and movements taught by Flip&Twist are based on the techniques utilized in gymnastics, ninja warrior, parkour & free running, and are intended to be performed only while under the strict supervision of a trained professional. I hereby assume all risks and hazards incidental to my practice of said routines, exercises, and movements if I choose to perform or practice said routines and/or exercises and/or movements outside of class, whether or not I am under said supervision, including, but not limited to, any routine, exercise, or movement similar to or associated with gymnastics, ninja warrior, parkour, free running, or anything taught or advocated by Flip&Twist. *

I have read and agree to the above clause.

I grant permission to the employees and or representatives of Flip&Twist to authorize and obtain emergency medical care from any licensed physician, hospital, or medical clinic in the event that such care is required. *

I have read and agree to the above clause.

I grant permission to Flip&Twist to use my name, likeness, and photograph for the purpose of publicity, public relations, editorial, or other advertising purposes without restriction as to frequency or duration. *

I have read and agree to the above clause.

I have carefully read this agreement before executing it and acknowledge that I am signing this agreement voluntarily and with the full intent of releasing Flip&Twist from any and all claims arising as a result of my participation in the classes, routines and exercises. *

I have read and agree to the above clause.

Name of Signer - MUST be Parent or Legal Guardian if Participant(s) is a minor *

First Name

Last Name

Signer's Birthday *

MM

DD

YYYY

Signer's Phone *

(###)

###

####

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####