We are excited to welcome you and your family to The Fear Management Workshop Summer Camp 2025!

To secure your spot for this session, please fill out the registration form below.

Tumbler's Info

Tumbler's Name

Gender

Male
Female

Date of Birth

T-Shirt Size

Will this be the tumbler's first time working with me in person?

What best describes what your tumbler is struggling with right now?

Mental block
An extreme, paralyzing fear of a skill they once possessed independently. In many cases still hesitates even with a full spot from coach.
General confidence
Struggling with confidence as a tumbler, yet not to the extent of experiencing a mental block.
Bad habits
The overall poor technique is hindering progress.
Plateaued
The issue isn't really about fear; it's more about a lack of progression in tumbling skills.
Other
The other options do not accurately describe the problems my tumbler is currently encountering.

Explain why you chose the above answer.

About how long has your tumbler been dealing with this specific tumbling issue?

What tumbling skill(s) are most important to work on during our time together

How did your family hear about Coach Levi's Fear Managment Workshop? (ex. Facebook, Instagram, friends, past attendee, etc)

What city and state will your family be traveling from?

Parent/Guardian Info

Relation to Athlete

Name

Phone Number

Emergency Contact Info

Relation to player

Name

Phone Number

Terms (Assumption of risk, Release of liability, Video/photo release, Refund policy)

Assumption of risk - The minor's parent and/or legal guardian, understand the nature of tumbling and the minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I fully understand that tumbling involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or in-actions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the minor named on this digital registration form under "Tumbler's name"; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of participation in tumbling.

Release of liability - I do hereby release, protect, indemnify and hold harmless, Coach Levi Nickson, Tumble Smart Athletics LTD. CO. , it's employees, board members and volunteers, from and against all claims, liabilities, suits, actions, or proceedings which may a rise out of, or in any way be connected with, any illness, injury or even death occurring during on-site or off-site tumbling. This indemnity shall include, but shall not be limited to, indemnification with respect to any costs of defense and attorney fees.

Video/photo release - I hereby give Coach Levi Nickson and Tumble Smart Athletics LTD. CO. permission to use photographs and video recordings of my child for all purposes, including advertising, training and social media posts.

Refund policy- I understand that the amount that I pay today will not be refunded for any reason. However, the amount paid today will be credited in full towards a future service with Tumble Smart or Coach Levi.

I, the undersigned, agree to the terms above.

Payment options

One time payment of: ($892.00)
By paying in full today, you will receive over a 10% discount on the total cost of the workshop, which is already included in the price displayed.
50% Deposit of: ($992.00)
50% deposit to secure spot in Workshop. Additional $496 will be due one week before workshop (July 18th, 2025).

Running Total

$892.00

Coupon Code

Total

$892.00

Purchase ProtectionRECOMMENDED

Add Purchase Protection for a small fee and get a 100% refund of your registration purchase should you be prevented from attending due to a qualifying unforeseen circumstance. (Full Terms)

Why protect your registration purchase? Purchase Protection covers:

Severe Illness and Injury

COVID-19

Hospitalization

Death in Family

Transportation Failure

Crime and Home Emergency

Employment Obligations

Acts of Nature

Legal Obligations

Purchase Protection covers many common unforeseen circumstances, but exclusions apply. View full List of qualifying circumstances and exclusions.

Yes, protect my event registration purchase (Recommended) $75.82

No thanks, I am willing to risk losing $892.00. I understand I cannot add this later.

* Terms, conditions and exclusions apply. Not available for or applicable to events, attendees, or travel outside of the USA. Purchase Protection is a service offered by Purchase Protection LLC. Purchase Protection is not an insurance policy. It is a service that will refund you 100% of your event fees, taxes and dues should you be prevented by unforeseen circumstances from attending the event. Purchase Protection does not apply to, and will not reimburse, merchandise purchases and charitable donations. Purchase Protection fees will be charged as a separate transaction. Any changes made to your purchase will not change the amount covered in this agreement.

Read Full Terms and Conditions

Billing Information

Name

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Credit Card

Visa
Mastercard
American Express
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Address

Mobile Phone Number

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