OVER THE TOP GYMNASTICS ACADEMY, INC .
11 MCKEON ROAD
WORCESTER, MA 01610
508-752-7676

PERMISSION SLIP

It is with the understanding that I will drop my son/daughter off at the gym between _________________pm on _____________________, and pick him/her up BY ______________am _________________ morning. The Gymnastic Academy will

be locked after 10:30pm. No one will be allowed outside the facility at any

time. These measures are for the safety of all the children. Our staff will be staying overnight to properly schedule the activities of the evening and chaperon the entire event. We will provide ___________________ at night and juice and donuts for morning. All children bring workout clothes and something to sleep in. They will also need to bring a sleeping bag and pillow. Please label all of your child's belongings with his/her name. You may snacks. Leave any valuables at home.

I, _________________________________, give my son/daughter _________________________________ permission to attend the SLEEPOVER at Over the Top Gymnastics Academy, Inc. at 11 McKeon Road, Worcester, MA .

If my child, for any reason, is not following the rules and regulations of the gym at any time during this event, the staff will contact me for my child’s immediate dismissal.

I am fully aware of and appreciate the risks, including but not limited to, the risk of catastrophic injury, paralysis, and even death, as well as, other damages and losses associated with participation in gymnastics. I further agree that the Over the Top Gymnastics Academy, Inc., along with the employees, agents, officers, and/or directors of this organization, shall not be liable for any losses and/or any damages occurring as a result of my child(s) participation in this event.

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Parent Signature

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Emergency Contact Number

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Date