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All Star Academy of Gymnastics & Dance
Open Gym, Daytime Playtime, Parents Night Out, Special Event WaiverParticipant:___Is here for (Check One):Open Gym/Daytime Playtime___Parents Night Out___ Day Camp___Other (Specify)___Participants Birthdate:___/___/___Parents Name (If applicable) PLEASE PRINT:___Contact Phone Number:___Email:___Address:___City:___ State:___ Zip Code:___Emergency Contact Name:___Emergency Phone Number:___Acknowledgement of Risk and Waver of Liability
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All Starz Academy is a sports training facility.
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