• Child 1:

  • Child 2:

  • Child 3:

  • I certify that my child is in good physical/mental/emotional health, is permitted by his/her doctor to participate in gymnastics activities. I hereby authorize simple first aid and consent to any x-ray/exam/medical or surgical diagnosis which is deemed necessary in the event of an injury. I understand that any activity that involves height, flight and rotation increases the risk of serious injury. I hereby waive and release any and all claims that I may have against Tovi’s Gym, Tova Schleifer, her assistants or representatives for myself or my children, adopted or otherwise, my heirs and executors, their agents or Tovi’s Gym Inc. I understand that my insurance coverage from Tovi’s Gym, is a secondary policy which is effective only after my own personal health insurance and a $250 deductible has been paid. This insurance applies to all students 18 years and younger.

    Additionally, I have read through and understood all the rules and policies and will not hold Tovi’s Gym Inc. accountable for any misunderstandings on my part. I agree to follow the rules of the gym.