DEER PARK CHEERLEADING

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Deer Park Competition Cheer registration 2019 Season

CHEERLEADER INFO

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Email:

Gender:

Grade:

PARENT/GUARDIAN #1

Firstname:

Lastname:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

ALLEGIES?:

WAIVER INFORMATION

RELEASE OF LIABILITY - READ BEFORE SIGNING
DEER PARK COMPETITION CHEERLEADING PROGRAM
IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN ANY WAY IN THE DEER PARK COMPETITION CHEERLEADING LEAGUE PROGRAM, IT’S RELATED EVENTS AND ACTIVITIES I HERBY ACKNOWLEDGE, APPRECIATE AND AGREE THAT:
• THE RISK OF INJURY FROM THE ACTIVITIES INVOLVED IN THIS PROGRAM IS SIGNIFICANT, AND WHILE SKILLS, TRAINING, EQUIPMENT AND PERSONAL DISCIPLINE MAY REDUCE THE RISK, THE RISK IS SERIOUS AND DOES EXIST.
• I KNOWINGLY ASSUME ALL SUCH RISKS BOTH KNOWN AND UNKOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES OF OTHERS, AND ASSUME FULL RESPONSIBILITYFOR MY PARTICIPATION AND THE PARTICIAPATION OF MY CHILD FOR WHOM I’AM SIGNING THIS AGREEMENT.
• I AGREE THAT BY REGISTERING MY CHILD FOR THIS SPORTS PROGRAM I HOLD HARMLESS THE DEER PARK COMPETITION CHEERLEADING LEAGUE AND ALL OF THEIR COORDINATORS, PARTICIPANTS, OWNERS AND LESSERS OF PREMISES USED FOR ITS ACTIVITIES, WITH RESPECT TO ANY AND ALL INJURY,DISABILITY, DEATH OR LOSS OR DAMAGE TO PERSON OR PROPERTY.
FOR PARENTS AND GUARDIANS OF PARTICIPANTS
THIS IS TO CERTIFY THAT I, AS PARENT/GUARDIAN WITH LEGAL RESPONSIBILITY FOR THIS PARTICIPANT, DO CONSENT AND AGREE TO HER RELEASE AS PROVIDED ABOVE OF DEER PARK COMPETITION CHEERLEADING LEAGUE, AND , FOR MYSELF, MY HEIRS, ASSIGNS, AND NEXT OF KIN, I RELEASE AND AGREE TO INDEMNIFY AND HOLD HARMLESS THE RELEASEES FROM ANY AND ALL LIABILITIES TO MY MINOR CHILD’S INVOLVEMENT OR PARTICIPATION IN THESE PROGRAMS AS PROVIDED ABOVE, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, TO THE FULLEST EXTENT OF THE LAW.

PARTICIPANTS NAME:__________________________________________________________

PARTICIPANTS DOB:____________________________________________________________

PARENT / GUARDIAN SIGNATURE_________________________________________________

EMERGENCY PHONE #: _______________________EMAIL_____________________________

DATE SIGNED:_________________________

I HEREBY GIVE PERMISSION TO DP COMPETITION CHEER TO DEPOSIT MY “UNIFORM CHECK” $100 POST DATED 12/15/2015 IF I DO NOT RETURN THE CHEER UNIFORM BY 12/15/2015.

I UNDERSTAND THE UNIFORM CONSISTS OF THE FOLLOWING 5 PCS:
*LOG SLEEVE MID-RIFF
*TOGS, BOY-SHORTS
*SKIRT
*HAIR BOW
*TOP SHIRT-SHELL
(SNEAKERS, SOCKS, PRACTICE SHIRTS (if any) ARE NOT TO BE RETURNED)
*I ALSO UNDERSTAND THE UNIFORMS ARE THE SOLE PROPERTY OF DP COMPETITION CHEER LEAGUE AND MUST BE RETURNED IN CLEAN CONDITION UPON REQUEST ON OR BEFORE 12/15/2015
Print-cheerleader & parent name__________________________________________________

Home address__________________________________________________________________

Signature/Date:_________________________________________________________________

I/we agree with the above *

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Date:

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Deer Park Competition Cheer registration 2019 Season