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Emergency Contact Information

Studio Liability Release
Liability waiver and Authorisation to process personal data
(This form must mandatorily be signed by all members of The Little Gym® of Europe)

Acknowledgement of Risk and Waiver of Liability
I understand that there may be some risk of injury associated with participation in sport activities; and I agree to waive any and all claims of liability, release and hold harmless The Little Gym® of Europe (“TLGE”) and its franchisees in the event that such an injury may occur to my child, except in the case of malicious act or serious misconduct from TLGE or one of its franchisees.

Authorization to Seek Medical Attention
In the event of accident or injury, when parent, legal guardian or emergency contact are not available, I give my permission to The Little Gym® of City to procure medical attention.

Authorization to process medical data
Any medical information that I have given to The Little Gym® was given in good faith and I give my permission to TLGE and its franchisees to record and process it for the purposes and in the framework of the services provided by The Little Gym®.

Permission to take and publish pictures
By signing this document, I hereby give TLGE and its franchisees permission to take pictures or videos of my child in the context of The Little Gym® activities. I hereby give permission to TLGE and its franchisees to publish such pictures or videos on The Little Gym® social networks, on The Little Gym® websites or for internal use to TLGE. I am hereby informed that I can withdraw my permission at any time by sending a signed and dated request to The Little Gym® of City or to - as explained hereunder – or by mentioning on the present form that I do not provide my permission for the above.

Data Protection Clause
The LifeSkills Company S.A., 62 boulevard de la Woluwe, B-1200 Brussels, Belgium (enterprise number: 0475.164.891), a subsidiary of ITACA International S.A., is the controller of the personal data processing. It will process my personal data according to the Belgian Data protection Act of 8 December 1992 for providing the services I requested or the information I asked for about The Little Gym® Company, its services and promotions. I have the right to access my data and to rectify it. I also have the right to object to the use of my data for direct marketing purposes. I can exercise my rights by sending a signed and dated request, with a proof of my identity, to The Little Gym® of City [add your TLG location, address and e-mail address] or to The LifeSkills Company S.A. at More information on the processing of my personal data can be found on (

I, undersigned ________________________________________, have read and agree to these terms.