Stretch and Grow

The Fabulously Fun Fitness Program for Kids!!

PARTICIPATION FORM

Sandpiper Montessori Preschool

Child Care Center or Facility
Child’s classroom or child’s teacher
Child’s Name
Child’s Birthdate
- M
- F
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Parent / Guardian Waiver and Release Form
You give permission for my child to leave the classroom to participate in the 30-minute Stretch-n-Grow fitness session. During this time, you understand your child will remain on-site and under the supervision of the Stretch-n-Grow coach.
You agree that you are aware that the child named will be will be engaging in physical exercise involving various exercises, sports, coordination events, and general fitness training which could cause injury to him or her.
You understand that the child is voluntarily participating in these activities and is assuming all risks of injury that may result from engaging in any exercise program or sport related event including tripping, slipping, or falling on or off the premises.
You hereby agree to waive any claims or rights that you might otherwise have to sue the childcare center, Stretch-n-Grow, our employees, owners, officers, or agents for any injury that might occur. You understand that we will make no evaluation or recommendation as to whether or not the child is capable or deemed physically fit to engage in any activity. If the child has any physical or mental condition that may impair his or her ability to engage in any of the club activities, it is your responsibility to obtain a physician’s release statement. It is recommended you consult a physician prior to your child participating in any physical exercise program.
HEALTH DISCLOSURE: Please describe any injuries or health problems that may limit your child’s participation:
- None known
Photographs or videos of classes are occasionally used for marketing and promotion; an example is placing action shots from class on Facebook or the Stretch-n-Grow website. Children’s names are never disclosed. If you do not want your child’s photograph or video used, please check here:
Permission
- I do NOT give permission
- I give permission
Parent Name*
E-mail Address*
Date
Phone Number*
Parent Signature
- Yes
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PARTICIPATION FORM

Sandpiper Montessori Preschool

Parent / Guardian Waiver and Release Form

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