_____Beginner: No knowledge of this skill              
(Will utilize time doing Backhand Spring drills such as
cartwheels, round offs, and backward techniques)

_____Intermediate: Need to have cartwheel and round off               (Will utilize time learning drills for round offs and backhand springs)

_____Advanced: can do a backhand spring with a spot 
(45 minutes spent of round off rebound drills/ 45 minutes spent on  backhand spring drills) 
Cost: $20 prior to the clinic / $25 at the door. 
Cannot sign up over the phone without payment

Name_______________________________________ Age_____

Phone________________________

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_________

Ages 5 & Up  Cost $25    Check#_____Cash______CC______

 Mercury Gymnastics  10551 N. Ambassador Dr.,          880-9996