Registration

Athlete Registration - Single

USAIGC Athlete Registration Form

Single Athlete Registration Fee: $40.00

This form is for registering a single athlete only.
Membership Fees are non-refundable and non-transferable.
Payment is required and validated before processing.
Gymnast must be a member of a USAIGC/IAIGC Club in GOOD STANDING
This form is for paying by credit card only. To pay by check/mail use this printable athlete registration form.

ATHLETE MEMBERSHIP INFORMATION

New Member Renewal - If renewal, Member # Athlete Lookup
Gender	Competitive Level	Gymnastic Discipline
Women Mens	Copper 1 Copper 2 Bronze Bronze Diamond Silver Gold Platinum Premier	Artistic Gymnastics Rhythmic Gymnastics Fitness Warrior 5th Event

First Name *:
M.I.:
Last Name *:

Address

Street or POB:
City *:
State/Province *:
Zip *:
Country *:

Parent Email:

Date of Birth *:

/ /

High School Students
grade entering this season:

Not in H.S. Freshman
Sophomore Junior Senior

Gymnast's Primary Medical Insurance Carrier

USAIGC CLUB INFORMATION

Club:

Mailing Address:

Street or POB:
City:
State/Province:
Zip:
Country *:

ATHLETE REGISTRATION FEE

Credit Card Information

CC Type *:	Visa MasterCard AmEx
Card Holder First Name *:
Card Holder Last Name *:
Billing Address *:
Billing City *:
Billing Zip Code *:
Card Number *:
CVV2 *:
Expiration Date *:
Cardholder's Phone *:

USAIGC INSURANCE

Injury must occur during a sanctioned event.
Accident / Insurance Participate Accident Report must be filled out and filed with the USAIGC Office by the Coach, Trainer, or other attendant immediately following any injury; which prevents the gymnast from full activity for 24 hours or more, regardless of whether immediate medical attention is given.
The gymnasts club must be a member in good standing with the USAIGC
The gymnast must have a fully executed Athlete Registration Form on file with the USAIGC National Office.

USAIGC ATHLETE RESPONSIBILITIES

To be physically and psychologically prepared to participate in a USAIGC sanctioned event.
To give my consent to the USAIGC and their Host Organizations of any USAIGC sanctioned event, to provide, through a medical staff of its choice, customary medical / athletic attention, transportation and emergency medical services as warranted in the course of your participation in USAIGC sanctioned events.

Waiver and Release*:

I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, and even death as well as other damages and losses associated with participation in a gymnastics event.
I further agree that USAIGC, the Host Organization, and sponsor(s) of any USAIGC sanctioned event, along with the employees, agents, officers and directors of these organizations, shall not be liable for any losses or damages occurring as a result of my participation in the event, except where such loss or damage is the result of the intentional or reckless conduct of one of the organizations or individuals identified above.
I will follow all USAIGC Rules, Policies and Guidelines for the sanctioned event I am participating in.
I will conduct myself in an exemplary fashion during all USAIGC sanctioned events.

Parent / Guardian Authorization / Club Owner

As legal parent or guardian of the above named athlete, I hereby verify by my submitting this application, that I fully understand and accept each of the conditions listed in the above Athlete Membership Agreement permitting my child to participate in any USAIGC/IAIGC sanctioned event.

USAIGC Accident Insurance

OneBeacon Insurance - Blanket Accident Benefits
Accidental Death: $10,000.00. Dismemberment: $10,000.00
Medical & Dental Expense Benefit: $25,000.00 each - $100.00 deductable
Aggregate Limit of Liability $500,000.00

*I am at least 18 yrs. of age OR As parent or legal guardian

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