Please use this form in order to complete the liability waiver. Most fields are required. If a field does not apply to you or you do not know the information. please use N/A.Today's Date* Date Format: MM slash DD slash YYYY Registration Purpose*New RegistrationChange of InformationNew Registration or Change of Information?Name* First Last Child's Name or Adult Participant's NameDate of Birth* Date Format: MM slash DD slash YYYY Gender*FemaleMaleNon-Gender Specific2nd Child's Name First Last 2nd child's name or participantDate of Birth Date Format: MM slash DD slash YYYY GenderFemaleMaleNon-Gender Specific3rd Child's Name First Last 3rd child's name or participantDate of Birth Date Format: MM slash DD slash YYYY GenderFemaleMaleNon-Gender SpecificParent / Guardian Name* First Last Address* Street Address Address Line 2 City State ZIP / Postal Code Email* Primary Phone*Work PhoneEmergency Phone*Emergency Contact* First Last Primary Insurance CompanyMedical Alert / Allergies / Physical LimitationsHow Did You Hear About Us?*WebsiteFriendDrove ByPrevious StudentBirthday PartyYellow PagesMagazine / AdOtherPlease Read and Review - Signature Required BelowWAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT ("AGREEMENT") In consideration of participating at Sacramento Elite Tumblers Gymnastics (SET Gymnastics), I represent that I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in the Activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis, and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the "releases" named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the Activity. I hereby release, discharge, and covenant not to sue SET Gymnastics, its respective administrators, directors, agents, officers, volunteers, employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the "releasees" or otherwise, including negligent rescue operations and further agree that if, despite this waiver and release of liability, and assumption of risk, I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost, which any may incur as the result of such a claim. I have read the WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT ("AGREEMENT") ROCK CLIMBING 1. I acknowledge that both my climbing and non-climbing related activities and use of any of SET Gym’s services or facilities at this location, all other SET Gym locations, or any off-site locations, entails significant risks, both known and unknown, which could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. Such risks include, among others, equipment failure, falling climbers, broken and/or falling holds, loose holds, as well as the negligence of belayers, other participants, third parties, and SET Gym. 2. I expressly agree and promise to accept and assume all of the risks existing in these activities, both known and unknown, whether caused or alleged to be caused by the ordinary (but not gross) negligent acts or omissions of SET Gym. My participation in these activities is purely voluntary, and I elect to participate in these activities in spite of the risks. 3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless SET Gym from any and all claims, demands, or causes of action, which are in any way connected with my participation in these activities or my use of SET Gym's equipment or facilities, including any such claims which I, my children, parents, heirs, assigns, personal representative and estate have or may have that allege ordinary negligent acts or omissions of SET Gym. I UNDERSTAND THAT THIS RELEASE INCLUDES ALL CLAIMS AGAINST SET Gym ARISING FROM ITS ORDINARY NEGLIGENCE, BUT DOES NOT INCLUDE CLAIMS ARISING FROM SET Gym’s ALLEGED GROSS NEGLIGENCE. 4. Should SET Gym or anyone acting on its behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. 5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in the activities, or else I agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical condition which could interfere with my safety while participating in these activities, or else I am willing to assume, and bear the costs of, all risks that may be created, directly or indirectly, by any such condition. 6. I agree that the validity and enforceability of this Release of Liability and Assumption of Risk will be governed by the substantive law of California, without regard to its conflict of law rules. 7. I agree to abide by the rules of the facility. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in these activities, I may be found by a court of law to have waived my rights to maintain a lawsuit against SET Gym for any claim that I released by signing this document.Parental Consent AND I, the minor's parent and/or legal guardian, understand the nature of the above-referenced activities and the minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, covenant not sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releases from all liability, claims, demands, losses or damages on the minor's account caused or alleged to have been caused in whole or in part by the negligence of the Releases or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, HOLD HARMLESS each of the Releases from any litigation expenses, attorney fees, loss liability, damage, or cost any Release may incur as the result of such claim.Consent of Treatment of Minor Should it be necessary, in the opinion of a staff member of SET Gymnastics to render first aid and assistance to the participant(s) listed above, I hereby grant permission to the staff of SET Gymnastics and other medical personnel to render such aid and assistance as they may deem necessary. I have carefully read this consent for treatment of a minor and fully understand its contents.Agreement to Terms* I HAVE READ AND AGREE TO TERMS Printed Name of Parent / /Legal Guardian* First Last Signature*Please use your mouse or touch-screen to sign here.