|SSGA/Massachusetts State TOPs CAMP July 18-20, 2014
South Shore Gymnastics Academy in Rockland, MA will be the host for a Massachusetts State TOPS Camp, being held July 18-20, 2014. The camp will focus on gymnastics basics and TOPs skills. We will touch on the physical abilities aspect during this camp. The camp will conclude with at TOPS test at 10 am on Sunday, July 20 (you must register separately through USAG to participate in this test.) Gymnasts must have a current USAG membership and be between ages of 6-10 years old. Gymnasts do not have to attend with a coach-however coaches are encouraged to attend and are FREE with a participating gymnast(s). If a coach would like to attend for educational purposes, the cost is $50.00 per coach. Coaches must submit name and USAG information, and must be current up to date members of USAG to be allowed on the gym floor and sign a waiver at SSGA. Parents are welcome to view from our lobby area but are not allowed into the gym. Gymnasts MUST have a completed, paid registration form with a waiver signed by a parent in order to be enrolled in the camp.
Tentative Camp Schedule:
Friday, July 18: 4-7 pm
Saturday, July 19: 10-5- Double workouts with conditioning & dance.
There will be a 1 hour lunch break-Lunch is on your own.
Sunday, July 20: TOPs TEST 10 am start (must register SEPERATELY online through USAG for this test)
(Entry into the TOPS CAMP does not automatically enter you into the TOPS test on 7/20/14. You must register for the test at least 7 days before the test at http://usagym.org/pages/women/updates/tops.html)
Tentative Staff: Travis Cherrier (from Legacy Gymnastics in Minnesota), Laurie DeFrancisco (Arena in CT), Robert & Nikki McElroy (GLC-MA), Haley Merra (Former ballerina from London Royal Ballet Company), Matt Yellis (Atlantic Gym and NH TOPs State Manager) and MANY, MANY MORE!
Cost: $150.00/gymnast (checks to SSGA) for the entire camp! www.southshoregymnasticsacademy.com
(We need a certain amount of attendees to run the camp. If we don’t run it due to low attendance, all monies will be refunded.)
Camp is held at: South Shore Gymnastics Academy, 22 Reservoir Park Dr., Rockland, MA
Host hotels: Comfort Inn, 850 Hingham St, Rockland, MA (walking distance to gym & many restaurants) 781-982-1000
Holiday Inn, 929 Hingham St, Rockland, MA 781-871-0545 (.25 miles away)
(Snacks/Drinks/Saturday lunch not included. WATER ONLY in the gym area at SSGA -No Gatorades will be allowed into the gym. This cost also does not include the hotel or TOPS test-those costs are separate.)
Gymnasts are not entered into the camp until paid in FULL- no email/phone entries unless they are accompanied by credit card information. Parents must sign waiver on registration form.
Questions? Call Rett at 781-878-3300 or email: firstname.lastname@example.org
TOPs Camp Registration Form
July 18th (4-7 pm) and 19th (10 am -5pm with a 1 hour lunch break)
July 20-Gymnasts can sign up separately for the TOPs test being held at SSGA- 10 am start (must register SEPERATELY online through USAG for this test. Entry into the TOPS CAMP does not enter you into the TOPS test on 7/20/14. You must register at least 7 days before the test at http://usagym.org/pages/women/updates/tops.html)
Gymnasts Name: _________________________________________ Date of Birth: ___________________
2013-2014 Competitive Level: ____________ USAG #: _________________
Parent Name: ________________________________________ Contact Phone #: _______________________
Address: ______________________________________ City: __________ State: _______ Zip: ____________
Coaches Name: ______________________________________USAG/EXP #: ______________
Cost $150.00/Gymnast- payable to SSGA by check /Coaches w/ no gymnasts $50.00 Mail to: SSGA, 22 Reservoir Park Dr., Rockland, MA 02370
PARENT PLEASE SIGN WAIVER BELOW-
Permission to Participate/General Liability Waiver for Minor Child
MEDICAL AUTHORIZATION - authorize South Shore Gymnastics Academy (SSGA) to transport my child and/or ward to a doctor, hospital or other health care facility and to act in my place to obtain medical or hospital treatment.
RELEASE OF LIABILITY/INDEMNITY FOR PERSONAL INJURY - release SSGA, it's owners, instructors, employees, agents and servants, from any and all liability for personal injury to me and/or my child and/or ward as the result of any negligence arising out of or in the course of or in any way related to my or my child's use of the facilities, equipment, apparatus or premises of SSGA and/or my or my child's participation in any class, program, camp, competition or other event organized, run and/or sponsored by SSGA, whether at its facilities or elsewhere. On behalf of myself and my child and/or ward, I agree to indemnify and hold harmless the said SSGA and its owners, operators, instructors, employees, agents and servants from any and all claims, damages, demands, costs, expenses and compensation arising out of or in the course of or in any way related to any personal injury to me or my child.
USE OF IMAGES/NAME IDENTIFICATION - authorize SSGA to use images of me and/or my child and/or ward, both with and without name identification, for SSGA publicity, promotional and advertising purposes and release any and all claims and/or rights I and/or my child and/or ward might have as a result.
ACKNOWLEDGEMENT OF ACTIVITY RISKS - acknowledge my understanding and acceptance of the following:
1. that the activities offered by SSGA include active sports which can result in injury to participants and/or spectators;
2. that SSGA provides an observation area and that I have the option to remain in the observation area while my child and/or ward is in a class, working out or performing;
3. that in the event I choose to leave my child and/or ward before, during or after a class, workout or a performance, I hereby give SSGA my permission to use its discretion in determining whether my child and/or ward requires medical attention and, if so, to use its discretion in transporting my child and/or ward, selecting a health care facility and obtaining treatment for him/her;
4. that in my absence SSGA does NOT assume any responsibility for the care, custody, control, condition, health or well-being of my child and/or ward.
ACKNOWLEDGEMENT OF RULES AND POLICIES - acknowledge that SSGA has rules and policies in place regarding safety, use of facilities, conduct and the like. I have reviewed all currently in place (copies always available at SSGA facilities). I understand that failure to follow the rules in SSGA's discretion may result in revocation of all privileges provided by SSGA without refund of any prepaid fees.
I authorize SSGA to take pictures of my child and post them, either online or in print.
By checking this box/and or signing below, I certify that I have read and agree with the above AUTHORIZATIONS, RELEASES AND ACKNOWLEDGEMENTS.
Parent Signature: ______________________________________________ Date: ________
Printed Name of Parent: ______________________________