It's Bring a Friend week!

Please fill out this waiver for
your child to participate in class!

Thank you and we are excited to meet your child!

Parent First Name *

Parent Last Name *

Student 1 First Name

Student 1 Last Name

Student 1 Date of Birth

Phone *

Email *

Premier Friend's Name

Parental Consent

We, the undersigned parents/guardians do hereby give permission for our child to participate in the above stated activity. We certify that he/she is physically fit to participate in the activities of tumbling, dance or ninja class. We do hereby assume full responsibility for any risk of injury due to our child’s participation in this activity. We will not hold the instructors or Premier Tumbling & Dance or Premier Ninja Kidz responsible for accident or injury.

We further consent to emergency treatment by a physician in the event of injury to our illness of our child during his/her participation in such activities.

Parent Full Name - Digital Signature