If you receive a scholarship or discount, please use the PDF form and bring in to the Rc3 Gym to pay in person.
*Financial assistance is available. Applications are available at the front desk.
REGISTRATION DATES: July 27 - August 19, 2020
I hereby release RC3 from any and all liability of any kind of personal injury or property damage due to participation in this program. I certify that my child is in good health and is able to participate in all activities. If any attention is required for illness or injury, I give my permission to a staff member for such care. I give consent for my child to be photographed or videotaped and for those images to be used by the RC3 in the future. I understand that the RC3 will attempt to make up time lost due to bad weather, however if time cannot be made up I understand that no refund will be provided.
The parent(s) guardian(s) authorize the RC3 to obtain immediate medical care and consents to the hospitalization of, the performance of necessary diagnostic test upon, the use of surgery on, and/or the administration of drugs to his/her child or ward if an emergency occurs when he/she cannot be located immediately. It is also understood that this agreement covers only those situations which are true emergencies and only when he/she cannot be reached. The parent(s)/Guardian(s) understand that the provider will make every effort to contact them and/or their designated emergency contacts.
Please complete the following:
-
I/we will be responsible for payment of medical expenses.
-
Medical treatment costs are covered by:
If you receive a scholarship or discount, please use the PDF form and bring in to the Rc3 Gym to pay. *Financial assistance is available. Applications are available at the front desk.
Download Concussion Statement
