Cost: $25 per child


Name____________________Age_____Phone_________

Address_________________________________________

By signing this form, I understand and appreciate all risks of participating in this activity including the risk of catastrophic injury, as well as other and any possible damages.  I further agree that Mercury Gymnastics, along with the paid employees, volunteers, or other wise – shall not be liable for any losses or damages occurring as a result of my child’s participation in this event.

Parent’s Signature______________________Date_______
Cost:_____________Check#_____Cash______CC______
Ages 4 & up.  Must be potty trained. 
Do not have to be a member of the gym to attend.

Mercury Gymnastics 10551 N. Ambassador Dr.,
Kansas City, MO  64153(816) 880-9996