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We would like to take this opportunity to thank you for choosing to have your child’s party at Huff ‘n Puff in Jacksonville or Jax Gym in North Little Rock. The children and adults alike have a fantastic time at our parties.
Prior to the party, each person, under eighteen years of age who will be getting on gym equipment, including the trampoline, tumble track or pit, must have a liability form filled out by his/her parent or legal guardian. Adults will be expected to sign their own liability statement. We want to assure you that we have had no injuries during a birthday party; however, for insurance purposes, we must have a signed statement.
We have furnished for your convenience a copy of our liability form. You may either print off your own copies for your party or ask us for forms. Please have them completed by the parents and ready to be turned in to the Party Coach the day of your child’s party. If the parents are dropping off their child at either Huff ‘n Puff or Jax Gym, they may complete the form at that time.
Thank you for your cooperation. If you have any questions, please do not hesitate to call Shelly at 985-1818 (Huff 'n Puff) or Jackie at 945-1444 (Jax Gym).
Sheryl Zimmerman, Owner
HUFF ‘N PUFF REGISTRATION FORM FOR ALL PARTICIPANTS, MINORS AND ADULTS
WAIVER FOR BIRTHDAY PARTIES OR FUN NIGHTS at HUFF ‘N PUFF OR JAX GYM
|Child's Name||Age and Birthdate|
|Home Phone||Work Phone||Cell|
|Emergency Contact||Telephone Number||Cell|
|Additional Information that we might need to know about your child.|
I hereby consent to allow my child to participate in the Fun Night, Fun Time at the Gym, and/or Birthday Party Activities
involved with same offered by Huff ‘n Puff, Fitness, Dance and Gymnastics Center, Inc. (hereinafter called Huff ‘n Puff). I
further agree that Huff ‘n Puff, its respective owners, administrators, agents, along with its employees or volunteers, shall
not be held liable for any injury, loss or damage occurring at any time as a result of participation in these Huff ‘n Puff activities.
The risks involved in such activities are fully understood. This liability statement applies to both Huff 'n Puff and Jax Gym, NLR.
I hereby release, discharge, and covenant not to sue Huff ‘n Puff Fitness, Dance and Gymnastics Center, Inc., its respective administrators, directors, agents, officers, volunteers, and employees, other partici pants, and owners of business and premises on which the activity takes place (each considered as one of the Releasees” herein) from all liability, claims, demands, losses, or damages, on my account or behalf of my child, 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 release, waiver of liability and assumption of risk, I, or anyone on my behalf including my heirs, next of kin, executors, administrators, successors, and assigns, 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 may incur as the result of such claim.
PERMISSION FOR MEDICAL TREATMENT: I hereby confirm that my child is physically able to participate in the fun
activities involved with these stated, or other activities. I hereby authorize simple first aid and consent to any x-rays, exam
and medical and surgical diagnosis that are deemed necessary, and I assume full responsibility for those costs involved.
SIGNATURE PARENT/GUARDIAN_________________________________ DATE_________________
SIGNATURE OF PARTICIPATING ADULT
___ _________________________________________________________________ DATE _________________
Fun Night at the Gym is not a gymnastics class and is not a structured program. It is a fun time for children, ages four to twelve to participate in playtime while being carefully supervised by competent adults and older teenagers. The children participate in organized playtime, games and pitplay. Behavior that is considered ‘unsafe’ will not be tolerated and normal disciplinary measures will be taken. If misbehavior continues, parents will be called. Due to the nature of the play, injuries can occur, both of a serious and non-serious nature.
EACH PARTY INVITEE MUST HAVE A LIABILITY STATEMENT SIGNED BY HIS/HER PARENT OR GUARDIAN. PARTICIPATING PARENTS MAY SIGN A LIABILITY STATEMENT AT THE GYM.
A COPY OF THE LIABILITY STATEMENT IS ABOVE IF YOU CHOOSE TO MAKE COPIES FOR YOUR INVITEES. IF YOU DO NOT HAVE ACCESS TO A PRINTER, PLEASE STOP BY THE GYM.
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