PBA/BSA Waiver

As legal guardian of listed child(ren) and in consideration of participating in Perfect Balance Athletics, Inc. I represent that I understand the nature of this activity and that my child is qualified, in good health, and in proper physical condition to participate in such activity. And I, as the minor's parent and/or legal guardian, understand the nature of the above referenced activities and the minor's experience and capabilities and believe the minor to be qualified in such activity. I acknowledge that if I believe event conditions to be unsafe, I will immediately discontinue participation in the activity.

As legal guardian of above child(ren) I recognize that potentially severe injuries, including, but not limited to, permanent paralysis or death, can occur in sports or activities involving height or motion, including but not limited to gymnastics, tumbling, trampoline, dance, cheerleading and zip line activities. Being fully aware of these dangers, I voluntarily consent to the aforementioned person participating in any and all Perfect Balance Gymnastics and Cheer, inc. programs and activities and accept all risks associated with that participation.

in consideration for allowing my child to use these facilities, | on my own behalf and the behalf of my child(ren) and our respective heirs, administrators, executors and successors, hereby forever release and covenant net to sue Perfect Balance Gymnastics and Cheer, Inc. , it’s officers, directors, employees, volunteers and all others associated with the corporation from ail liability for any and all damages and injuries suffered by my child while under the instruction, supervision, or control of Perfect Balance Athletics.

In the event of an emergency, I would like my child to be taken to a hospital for medical treatment and hold Perfect Balance Gymnastics and Cheer, Inc., and its representatives harmless in their execution of its action. Additionally, I hereby agree to individually provide for all possible future medical expenses which may be incurred by my child as a result of any injury sustained while participating at or for Perfect Balance Gymnastics and Cheer, Inc.

We, despite all reasonable precautions implemented for safety, are fully aware of and appreciate that severe injuries, including permanent paralysis of even death, as well as other damages and losses associated with participation in the program.

I have read and understand this acknowledgement of risk and waiver of liability and medical authorization and | voluntarily affix my name in agreement.