CLASS REGISTRATION

Please only fill out this form AFTER you have successfully registered for a class.

REGISTRATION FORM

Athlete's Name

Birthday

Last Name

Parent/ Guardian Name:

Phone

Emergency Contact Name

Emergency Contact Phone #

Existing Medical Conditions

Previous Illness or Injuries

Allergies

Regular Medications

I recognize that potentially severe injuries including permanent paralysis or death can occur in any activity involving height or motion. This includes dance, trampoline, gymnastics, tumbling, and othe related activities. I hereby release Titan Elite, its officers, employees, teachers, and coaches from all liability for all damages ad injuries for my child while under the instruction, supevision, or control of Titan Elite. I agree to individually provide for the possible medical expenses which may occur. I have read and completley understand this acknowledgement of risk and waiver and is signed voluntairily as to its contender and intent.

I give permission for trained medical professionals to administer emergency medical treatment to my child should sickness or accident occur in my absence.

I give permission for my child to be in pictures and videos that may be shared on social media.

Your Signature

Select a date

Thanks!