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10/18/2019 Cheer "FALL CAMP" Registration Form
Cheerleader's First Name:
Cheerleader's Last Name:
Parent/Guardian First Name and Last Name:
Street Number and Name:
Cell/Home phone (No dashes):
EEYB will periodically display pictures of players and cheerleadeers on the EEYB website or other league sponsored publication.
I will allow my child's image to be shown:
List any known medical conditions and/or allergies:
List any required medications:
In case of an accident or illness, I hereby authorize a representative of EEYB to use his or her judgment in obtaining immediate medical care my the above named child.
I have read and understand the above information and by checking the attached box indicates my agreement with the terms set forth above.
RELEASE OF LIABILITY WAIVER
Despite all known and unknown risks, I hereby expressly and voluntarily remise, release, acquit, satisfy and forever discharge EEYB and staff, Henrico County and staff and Henrico Schools and staff and agree to hold it harmless of and from all, and all manner of action and actions or omission(s), cause and cause of action, suits, debts, dues, sums of money, accounts, reckonings, bonds, bills, specialties covenants, contracts, controversies, agreement, promises, variances, trespasses, damages, judgments, executions, claims and demands whatsoever, in law or in equity, including, but not limited to, any and all claims which allege negligent acts and/or omissions committed by EEYB and staff, Henrico County and staff and Henrico Schools and staff, whether the action arises out of any damage, loss, personal injury, or death to me or my child(ren)/ward(s), while participating in or as a result of participating in any of the ACTIVITIES. This Release of Liability, is effective and valid regardless of whether the damage, loss or death is a result of any act or omission on the part of EEYB and staff, Henrico County and staff and Henrico Schools and staff.
By checking this box I affirm that I have read and understand the Release of Liability Waiver and agree to the terms therein.
Fee Scale for Cheer Summer Camp:
* $25 (includes snack, drink, chants, cheers, stunts, and more)
**********(PLEASE NOTE THAT SINCE THIS IS AFTER THE DEADLINE, YOU WILL "NOT" RECEIVE A CHEER CAMP TSHIRT AS THEY HAVE ALREADY BEEN ORDERED)
Upon remittance of the camp registration fee, absolutely NO refunds will be given.
NOTICES: EEYB HAS THE RIGHT TO REJECT ANY REGISTRATION AT ANY TIME.
Office Use Only
* indicates required fields
$30.00 - Registration Fee + $5 Online Processing Fee (PLEASE NOTE THAT SINCE THIS IS AFTER THE DEADLINE, YOU WILL "NOT" RECEIVE A CHEER CAMP TSHIRT AS THEY HAVE ALREADY BEEN ORDERED)
East End Youth Basketball