DELAWARE VALLEY GYMNASTICS ACADEMY

A Junior Olympic Training Facility for Future Stars...Now under NEW Ownership!

3011 Philmont Avenue Huntingdon Valley, PA 19006 215.938.0900 Summer Session 2008 Application & Release Form GYMNASTICS CLASSES Summer Sessions 8 WEEKS $130 June 30 – Aug 22 Tuesday or Thursday Evenings Tiny Tots Age 3 – 5 .................. ..5:00-6:00 Girls Beg ....4:00-5:00 Girls Int/Adv .........5:00-6:00 Boys Age 6 & Up .....5:00-6:00 NO CLASSES on Friday, JULY 4TH PAYMENT POLICY A $50 non-refundable deposit for each week must accompany this application; the balance of the fee is to be paid on or before the first day of camp. We only accept cash or check. There is a $25 fee for returned checks. NO APPLICATION WILL BE ACCEPTED WITHOUT A $50 DEPOSIT FOR EACH WEEK. REFUND POLICY If full payment is made prior to camp, payment less the $50 non-refundable deposit is made until June 6th. No refunds after June 6th. Printable Version APPLICATION FORM Summer 2008 Child’s Name___________________________________ Birth Date_______________ Age_____ Address_______________________________________ City__________________ Zip________ Home Phone_______________________ Mom (work)_______________________ Mom (cell)_______________________ Dad (work) _______________________ Dad (cell)________________________ Emergency Contact: Name________________________________________ Relationship_______________________ Home Phone_______________________ Cell #____________________________                                                   TUE   TH Tiny Tots 5:00 – 6:00     (   )   (   ) Girls Beg 4:00 – 5:00     (   )   (   ) Girls Int/Adv .....5:00 – 6:00     (   )   (   ) Boys Classes ...5:00 – 6:00     (   )   (   ) Delaware Valley Gymnastics Academy 3011 Philmont Avenue, Huntingdon Valley, PA 19006 (215) 938-0900 2008 SUMMER CAMP & CLASSES RELEASE STATEMENT I (we) the undersigned student or legal guardian of a student for Delaware Valley Gymnastics Academy, Inc. for and in consideration of the enrollment of my child or a student for whom I have been granted legal custody hereby voluntarily and knowingly, execute this release with the expressed intention of effecting the extinguishments of and complete release from any and all claims, actions, demands or rights monetary judgement arising from any injury or physical harm which may arise from or be sustained as a result of the participation, practice and physical activity associated with the gymnastics, camp and related activities conducted by Delaware Valley Gymnastics Academy, Inc. Should transportation be required, my child and/or legal ward has permission to use camp transportation and I hold harmless Delaware Valley Gymnastics Academy Inc., teachers and staff from any and all injuries during camp. By the execution hereof I do further bind myself, my child, my legal ward, their heirs, executors, administrators, successors or assigns. EXECUTED THIS DAY_______________________ ____________________________________________ Signature of Parent/Legal Guardian Proud member of USA Gymnastics