Grace Cheer Academy Stars

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GCA Dancing Stars

* Participant's First Name:

* Participant's Last Name:

* Paricipants Date of Birth:

* Address:

* Parent 1 Last Name:

* Parent 1 First Name:

* Mother's Work Phone:

* Father's Work Phone:

* In case of emergency- Name & Phone Number:

* List any physical limitation::

* List any allergies or medical conditions (medical clearance may be needed):

* Email Address:

Uniform Size: Please specify Youth, Junior, or Adult Sizes (Numbers are Recommended)

* Top::

* Bottom::

* Shoes:

Would you like to be a::

The following must be read and signed for registration to be valid:
I/We the parent(s) or legal guardian(s) of the above-named candidate for a position on a Grace Cheer Academy Dance and/or Cheer team hereby represent that such is in good health and can participate in Grace Cheer Academy Dance and/or Cheer Team activities. I/We do further give my/our permission for such child to receive emergency medical and surgical treatment procedures of any kind and nature, which may be deemed advisable by any physician who may attend or treat such child at or during all Grace CheerAcademy activities, including going to or coming from Grace Cheer Academy practice, activities, or games. I/We hereby absolutely assume all risks and hazards incidental to such participation and release, absolve, and fully forgive and further agree to indemnify and hold harmless the Grace Cheer Academy and Dancing Stars and all persons and entities associated with the Grace Cheer Academy and Dancing Stars and, including persons transporting my/our child to and from activities, from or by reason of any injury known or unknown or death to my/our child or property damage whether the result of negligence or any other cause.
This agreement is given in consideration for my/our child?s being allowed to participate in the aforesaid activities.

CashApp Payment :$GraceYouthCenter *

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GCA Dancing Stars