Gymnastics is a very complete sport that increases children’s motor skills, discipline, selfesteem, concentration, flexibility, etc. These are a
few of the numerous benefits gymnastics brings
whether it is practiced on a recreational or
competitive level.
Child’s Name____________________________________________
Birth date _______________________________________________
Address_________________________________________________
City_______________________ State __________Zip____________
Email ___________________________________________________
Tuesday
Nuggets and Fries
$3.00
Wednesday
Sub 3”
$3.00
Thursday
Hamburger
$2.00
Friday
Pizza
$2.50
Note: Drink is not included in lunch price.
Athlete Membership Agreement
In consideration of my membership in Genie’s Gymnastics,
and my participation in Genie’s Gymnastics classes, events, and activities, I agree to be bound by each of the following:
1. Eligibility: I agree to comply with the rules of Genie’s
Gymnastics.
2. Readiness to Participate: I will only participate in those
Genie’s Gymnastics classes, events, competitions, and activities for
which I believe I am physically and psychologically prepared. Prior to
participation, I will have practiced my exercises and will perform only
those exercises which I have accomplish to the degree of confidence
necessary to assure I can perform them by myself, and without injury.
3. Medical Attention: I hereby give my consent to Genie’s
Gymnastics and/or the Host Organization to provide, through a medical
staff of its choice, customary medical/athletic training attention, transportation, and emergency medical services as warranted in the course of
my participation.
4. Waiver and release: I am fully aware of and appreciate the
risks, including the risk of catastrophic injury, paralysis, and even death,
as well as other damages and losses associated with participation in
gymnastics activities and events.
I further agree that Genie’s Gymnastics, and the sponsor of
any Genie’s Gymnastics event, along with the employees, agents, officers, and directors of these organizations shall not be liable for any
losses or damages occurring as a result of my participation in the event.
For any athlete who is not yet 18 years old: As legal parent or guardian
of this athlete, I hereby verify by my signature below that I fully understand and accept each of the above conditions for permitting my child to
participate in classes, events, competitions, and activities conducted by
Genie’s Gymnastics.
Parent Signature____________________________
Printed Name_______________________________
www.geniesgymnastics.com
$2.00
_______________________________________________________
Lake Worth, FL 33467
Hotdog
Any previous illness or injury the staff should be aware of?
6752 Lantana Rd Ste B
Monday
Emergency Contact ________________Phone _______________
Fax (561)868-0208
Lunch Menu
Father’s Name ___________________Phone _______________
(561)868-0288
* Since we don’t leave the premises, Wednesdays we bring special entertainment to our facility. And to make your life a bit easer, we have a
lunch option for you.
Mother’s Name___________________ Phone _________________
Summer Camp 2013
Flexibility describes our program. You can sign
up for a day or two, for a week or for the whole
Summer break. You just choose the days you
want. Camp hours are from 9:00am to 4:00pm,
however you can take advantage of the early
drop off option.
Home Phone ________________ Mobile ______________________
Genie’s Gymnastics
Our Summer Camp program offers the perfect
mix of fun and gymnastics that will keep your
child motivated and wanting to come back.
Summer Camp 2013
Registration fee
$
35.00
Camp hours: 9:00am - 4:00pm (early drop-off and late pickup will be an extra $5.00 per day)
Whole week $185
4 Days/Week $155
3 Days/Week $120
2 Days/Week $80 1 Day/Week $45
* Add $9.00 to daily rate for Wednesdays special entertainment
Initials Here 10% Discount for 5 whole weeks or more (not including the weeks with the *)
* Payment is not refundable or transferable to another program or account
Payment is due one week prior to the scheduled week. If you don't pay by then you may lose your space.
A late fee of $10.00 will be charged if payment is received the same week your child is booked for camp.
No Make ups
Total
Week 1
Mon Jun 03 Tue Jun 04 Wed Jun 05
Thu Jun 06
Fri Jun 07
Week 2
Mon Jun 10 Tue Jun 11 Wed Jun 12
Thu Jun 13
Fri Jun 14
Week 3
Mon Jun 17 Tue Jun 18 Wed Jun 19
Thu Jun 20
Fri Jun 21
Week 4
Mon Jun 24 Tue Jun 25 Wed Jun 26
Thu Jun 27
Fri Jun 28
Week 5*
Mon Jul 01
Tue Jul 02
Wed Jul 03
Thu Jul 04
Fri Jul 05
Week 6
Mon Jul 08
Tue Jul 09
Wed Jul 10
Thu Jul 11
Fri Jul 12
Week 7
Mon Jul 15
Tue Jul 16
Wed Jul 17
Thu Jul 18
Fri Jul 19
Week 8
Mon Jul 22
Tue Jul 23
Wed Jul 24
Thu Jul 25
Fri Jul 26
Week 9
Mon Jul 29
Tue Jul 30
Wed Jul 31
Thu Aug 01
Fri Aug 02
Week 10 Mon Aug 05 Tue Aug 06 Wed Aug 07
Thu Aug 08
Fri Aug 09
Week 11 Mon Aug 12 Tue Aug 13 Wed Aug 14
Thu Aug 15
Fri Aug 16
Week 12 Mon Aug 19 Tue Aug 20 Wed Aug 21
Thu Aug 22
Fri Aug 23
Payment
Date