Child/Children Information
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Parent/Guardian Information
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Assumption of Risk and Waiver of Liability
  • CampXTreme Student Information & Release forms

    I fully understand that Maverick All-Star Tumblers, MACD LLC staff members are not physicians or medical practitioners of any kind. With the above in mind, I hereby release Maverick All-Star Tumblers, MACD LLC staff to render first aid to my child or children in the event of any injury or illness, and if deemed necessary by the Maverick All-Star Tumblers, MACD LLC staff to call our doctor and to seek medical help, including transportation by a Maverick All-Star Tumblers, MACD LLC staff member or its representatives, whether paid or volunteer, to any health care facility, hospital or the calling of an ambulance for said child should the Maverick All-Star Tumblers, MACD LLC staff deem this to be necessary. We also authorize the physician and/or hospital to per-form treatment to any illness or injury to my/our child. I/We authorize payment for treatment, either personally or through our family health insurance.
    We, the staff of Maverick All-Star Tumblers, MACD LLC recognize our obligation to make our students and their parents aware of the risks and hazards associated with the sport of gymnastics, trampoline, tumbling, cheerleading, dance, ropes course elements, rock wall and all other activities. Students may suffer injuries, possibly minor, serious, or catastrophic in nature. Gymnastics, trampoline, tumbling, cheerleading, dance, ropes course elements, the rock wall and all other activities affiliated with Maverick All-Star Tumblers, MACD LLC can be dangerous and can lead to injury.
    Parents should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and the coach’s instructions. Maverick All-Star Tumblers, MACD LLC it’s coaches, and other staff members will not accept responsibility for injuries sustained by any student during the course of gymnastics, trampoline, tumbling, cheerleading, ropes course ele-ments, the rock wall, dance instructions, open workouts, or in the case of any exhibition, competition, special event, or camp/clinic in which he or she may participate in while traveling to or from the event. With the above in mind, and being fully aware of the risks and possibility or injury involved, I consent to have my child or children participate in the programs offered by Maverick All-Star Tumblers, MACD LLC my executors, or other representatives, waive and release all rights and claims for damages that I or my child may have against Maverick All-Star Tumblers, MACD LLC and/or its representatives whether paid or volunteer. I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage, which I con-sider adequate for both my child’s protection any my own protection. I also understand that it is the parents’ responsibility to warn the child about the dangers of gymnastics and injury. The parent should warn the child according to what the parent feels appropriate Maverick All-Star Tumblers, MACD LLC will only warn the child through “Safety Rules” and our teaching style and progres-sions.

    ASSUMPTION OF RISK, WAIVER OF LIABILITY,
    MEDICAL/TRANSPORTATION/WATER ACTIVITIY/PHOTO RELEASE AND AUTHORIZATION

    (1) I recognize that severe injuries, including permanent paralysis or death can occur in sports or activities involving height or motion, those activities including but not limited to gymnastics, tumbling, trampoline, martial arts, dance, cheerleading, ball sports, swimming and diving. In addition I recognize that swimming or any activity in or around water can result in brain damage or drowning. I am also aware that participation in certain activities including but not limited to day camps involves transporta-tion to and from field trips and such transportation could cause injury or death in a vehicular accident. Being fully aware of these dangers, I hereby give consent for my child(ren) to participate in any and all activities I ACCEPT ALL RISKS associated with such participation.
    (2) In consideration for my 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 Camp-X-Treme, Maverick All-Star Tumblers, MACD LLC and all their respective officers, directors, shareholders, employees, contractors and volun-teers from all liability resulting from damages or injuries incurred as a result of participation including those resulting from acts of negligence.


    CHECK ALL THAT APPLY:

    1. TRANSPORTATION: 
    I hereby give consent for my child to be transported and supervised by the operation’s employees:

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  • I hereby givemy consent for my child to participate in Water Activities including:

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Mediacl Authorizations and Information
  • AUTHORIZATION FOR EMERGENCY MEDICAL ATTENTION:

    In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:

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Special Needs and Medical Information Sheet
  • If my child needs medication while in the care of Maverick, MACD LLC staff member, I have filled out the Medication distribution consent form (available at the front desk) and have provided proper proof from my Childs physician of my Childs prescription
  • I have filled out this special needs and medical information sheet correctly and to the best of my knowledge
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