OKLAHOMA GOLD BIRTHDAY PARTY WAIVER Question Title * 1. Parent/Guardian Contact Information Name Email Address Phone Number Question Title * 2. Date of Party Date of Party Date Question Title * 3. Name of Child(ren) Question Title * 4. I agree and consent to the following: SPORTS PARTICIPATION CAN BE DANGEROUS. I recognize that severe injury, including permanent paralysis or death can occur in any activity involving height or motion, those activities including but not limited to gymnastics, tumbling, trampoline, martial arts, dance, and cheerleading. Being fully aware of these dangers, I hereby give my consent for my child(ren) to participate in any and all programs and activities at Oklahoma Gold Gymnastics, Inc and I ACCEPT ALL RISKS associated with such participation. In consideration for me or my child(ren)'s participation I hereby, for myself and my child(ren) and our respective heirs and successors, PROMISE NOT TO SUE and FOREVER RELEASE Oklahoma Gold Gymnastics, Inc. and it's respective officers, directors, shareholders, employees, contractors and volunteers from all liability resulting from damages or injuries incurred as a result of participation including those resulting from acts of negligence. In the event of an accident or emergency I hereby authorize my child(ren) to be transported to a hospital for medical treatment and I hold Oklahoma Gold Gymnastics, Inc. and their representatives harmless in the execution of such. Additionally, I hereby agree to individually provide for all medical expenses which may be incurred by myself or my child(ren) as a result of any injury sustained while participating at or for Oklahoma Gold Gymnastics, Inc. I am aware that individual or group publicity photos or videos may be taken from time to time and in consideration for me or my child(ren)'s participation. I hereby grant my permission for my child's likeness to be used in publicity or advertising. I have read and understand this (1) ASSUMPTION OF RISK and (2) WAIVER OF LIABILITY and (3) MEDICAL AUTHORIZATION and (4) PHOTO RELEASE and I VOLUNTARILY affix my name in agreement. Question Title * 5. PARENT/LEGAL GUARDIAN ELECTRONIC SIGNATURE Question Title * 6. Confirm Date Todays Date Date Submit