Which Elite location are you registering for?*MilledgevilleWhich Daycare? If party just type party/birthday child's nameChild's First and Last Name* Child's Age* Birthdate* Grade* Primary Phone* Parent's Email* Mailing Address* City* Zipcode* State* Mother's Name* Employer Cell Phone Number Work Phone Number Father's Name* Employer Cell Phone Number Work Phone Number Emergency Contact 1 Name* Relationship* Phone Number* Emergency Contact 2 Name* Relationship* Phone Number* Any health problems?* Yes No If yes, please explain Any allergies?* ReleaseI hereby authorize Elite School LLC to act for me according to their best judgement in any emergency requiring medical attention. The undersigned hereby acknowledges that participation in recreational programs involves inherent risk of physical injury, catastrophic injury, or even death. The undersigned assumes all such risks and agrees to waive and release Elite School LLC, its owners, employees, and affiliates from any liability for injuries or death incurred while involved in a program on or off the premises. The undersigned also assumes all medical costs incurred as a result of such an accident. Please type the following. This will serve as your digital signature.Your Name First Last Guardian For First Last Date MM slash DD slash YYYY Initial - I give permission to Elite Gym to use pictures of my child to post on the Elite Facebook page and Website.* NotesCAPTCHA Δ
