Fill Out Our Online Waiver Guest's Name*Birthdate* Date Format: MM slash DD slash YYYY Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent's Name* First Last Email* I am aware that participation in gymnastics involves risk and possible injury. I understand and agree that Starz Gymnastics Academy and its staff will assume NO responsibilities for injury or medical expenses incurred by my son/daughter or myself. My child (or I) has (have) no physical, mental, or emotional problems that would interfere with participation in this program.Digital Signature (First and Last Name)*Date* Date Format: MM slash DD slash YYYY What to wear: T-shirt and shorts, leotard or warm-up suit is recommended. No baggy clothing, zippers, belts, buckles or jewelry. No shoes, socks are optional and long hair must be tied back. This iframe contains the logic required to handle Ajax powered Gravity Forms.