2009 Cheer Camp Registration Form

2009 Cheer Camp Registration Form

Cheer Camp: June 15th - 19th, 2009 - Times - 5:30pm - 8:00pm Richland Park practice field.

Cost is $20.00 non-refundable, to be paid on or before first day of camp. Cheerleaders will receive a T-shirt on final day of camp.

Cheer Team: _____6/7/8 _____9/10 _____11/12

Child’s Name:___________________________________________________ Date of Birth: _____________________

Address:___________________________________________ City, State:______________________ Zip:__________

Has child ever cheered? yes or no Experience:_____________________________________________________

Did child attend last year’s camp? yes or no

T-shirt size: (circle one) youth or adult (circle one) Sm Med Lg XL XXL

Parent’s Name:______________________________________________ Home Phone #:____________________

Cell Phone #:__________________________________________ Work Phone #:____________________________

Emergency Contact::____________________________________________ Home Phone #:_________________

Cell Phone #:__________________________________________ Work Phone #:____________________________

Release of Liability

I understand by the very nature of the activity, cheerleading carries a risk of potential injury. No matter how careful the child and coach are, I understand that there is a risk of injury. The risk includes minor injuries such as broken bones, dislocations and muscle pulls. The risk also includes catastrophic injuries such as permanent paralysis or even death from landing or falling on the back, head or neck. The undersigned agrees, individually and on behalf of the child, that the child, by and through the undersigned or any other person, will not institute or commence any action at law or equity for any damage of any kind that may be sustained by the child as a result of participation in the program. The undersigned further agrees, individually and on behalf of the child, to release, indemnify and hold harmless the organization, its successors, members, directors, officers, coaches, sponsors and volunteers from any claims, demands or actions at law or equity that may subsequently be brought by or on behalf of the child to recover for injuries or damages, including claims for contribution or indemnification made by third parties, arising out of injuries resulting from participation in the program.

The above cheerleader has my permission to participate in the PYFL Cheer Camp.

________________________________________________________________________________________________

Signature of Parent or Legal Guardian Date