ELGIN CHEER, INC. – XPLOSION CHEERLEADING


INC/XPLOSION CHEERLEADING”, IT'S OFFICERS, DIRECTORS, COACHES AND VOLUNTEERS, ANY CLAIM OR CLAIMS. FOR INJURIES OR ILLNESS, WHICH MAY RESULT FROM THE ABOVE CHILD'S PARTICIPATION IN SAID PROGRAM. I/WE FURTHER AGREE TO DEFEND AND INDEMNIFY “ELGIN CHEER, ...

ELGIN CHEER, INC. – XPLOSION CHEERLEADING - REGISTRATION FORM MAKE CHECKS PAYABLE TO “ELGIN CHEER”

CHILD’S NAME: ______________________________________________________________________ AGREEMENT DATE: _____ - _____ - 20__ FIRST MI LAST ADDRESS: __________________________________________________________ ZIP: ___________ PHONE: _________-________-__________ EMAIL: PLEASE PRINT: __________________________________________________________________________________________________ GRADE IN FALL 20__: ______ CHILD’S BIRTHDATE: ______ - ______ - ______ AGE ON AUG. 31ST, 20__: ______ COPY OF BIRTH CERTIFICATE Y/N

I/WE CONSENT TO THE ABOVE MENTIONED CHILD TO PARTICIPATE IN “ELGIN CHEER, INC/XPLOSION CHEERLEADING”. I/WE DO EXPRESSLY WAIVE FOR OURSELVES AND FOR MY/OUR CHILD, AGAINST “ELGIN CHEER, INC/XPLOSION CHEERLEADING”, IT’S OFFICERS, DIRECTORS, COACHES AND VOLUNTEERS, ANY CLAIM OR CLAIMS FOR INJURIES OR ILLNESS, WHICH MAY RESULT FROM THE ABOVE CHILD’S PARTICIPATION IN SAID PROGRAM. I/WE FURTHER AGREE TO DEFEND AND INDEMNIFY “ELGIN CHEER, INC/XPLOSION CHEERLEADING”, IT’S OFFICERS, DIRECTORS, COACHES AND VOLUNTEERS, OF AND FROM ANY AND ALL CLAIMS, ACTIONS AND LAWSUITS OF WHATSOEVER KIND OR NATURE WHICH MAY HEREAFTER BE BROUGHT BY THE ABOVE CHILD OR BY ANYONE PURPORTING TO ACT ON HIS/HER BEHALF, WHETHER SAID CLAIM, ACTION OR LAWSUIT ALLEGIES NEGLIGENCE OR OTHER WRONGFUL CONDUCT AGAINST SAID “ELGIN CHEER, INC/XPLOSION CHEERLEADING”, IT’S OFFICERS, DIRECTORS, COACHES AND VOLUNTEERS OR OTHERWISE, INCLUDING THE USE OF TEAM PHOTOS/PROMOTION ON IT’S WEBSITE AND/OR FACEBOOK PAGE. I/WE UNDERSTAND THAT “ELGIN CHEER, INC/XPLOSION CHEERLEADING” ONLY LOANS THE COMPETITION UNIFORM USED BY MY/OUR CHILD, WHICH WILL BE ISSUED PURSUANT TO THE PAYMENT OF HIS/HER REGISTRATION FEE. I/WE WILL RETURN THE UNIFORM WHEN IT BECOMES DUE AT THE END OF THE SEASON AND THAT ANY LOST, DAMAGED OR UNRETURNED UNIFORM IS THE RESPONSIBILITY OF OUR FAMILY. I/WE HEREBY ACCEPT THE FINANCIAL RESPONSIBILITY TO REIMBURSE “ELGIN CHEER, INC/XPLOSION CHEERLEADING” FOR SAID UNIFORM IN THE EVENT IT IS LOST, DAMAGED OR OTHERWISE NOT RETURNED. I/WE RECOGNIZE THIS DOCUMENT AS A LEGAL AND BINDING CONTRACTUAL AGREEMENT. I/WE HAVE READ AND UNDERSTAND THE SAME AND HAVE SIGNED THE SAME AS OUR OWN FREE ACT AND DEED. PARENT/GUARDIAN SIGNATURE: __________________________________________________________________________________________ PRINT NAME: _______________________________________________________________________ AGREEMENT DATE: ______-______- 20__ CASH $ __________ CHECK # __________ CHECK AMT $ _________ CREDIT CARD $ _________ BALANCE DUE $ _________ MEDIA CONSENT: YES NO PARENT/GUARDIAN SIGNATURE: ______________________________________________________ ELGIN CHEER WEBSITE, XPLOSION ATHLETICS FACEBOOK AND/OR XPLOSION ATHLETICS SPECIFIC TEAM PAGE ********************************************************************************************************************* TEAR OFF RECEIPT OR COPY PAGE FOR PARENT/GUARDIAN CASH $ __________ CHECK # __________ CHECK AMT $ _________ CREDIT CARD $ __________ BALANCE DUE $ _________ DATE: __________

Recommend Documents
I fully understand that Elgin Cheer, Inc. owners/staff members are not physicians or medical practitioners of any kind. With that being understood, I hereby release Elgin Cheer, Inc. owners/staff to render temporary first aid to my child in the event

Oct 21, 2017 - communications sent to all Derry Demons and Windham. Wolverines members (minimum 3x). LIBERTY LEVEL – $100. • Business logo printed ...

#8 Lexie Silva Committed. Forward, Midfielder, Defender. DOB: 3/28/98 Grad Year: 2016. GPA: 3.70 Acalanes HS. Email: [email protected] Phone: 925-915- ...

5:30-7:45 StarBurst - Youth Level 1. 6:30-7:45 StarDust – Mini Level 1. Wednesday. 5:45-7:45 Shooting Stars - Jr. Level 2. 5:45-7:45 Electra – Sr. Level 2. 5:45-7:45 Super Novas – Sr. Level 4. 7:30-9:30 StarBlaze – Sr. Co-Ed Level 3. 7:30-9:3

Little Leader Cheer Camp. For attending the mini-camp, your child will also receive a t-shirt that matches one of our high school cheerleading shirts! They will.

Aug 19, 2017 - Permission to Participate and Medical Release. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor participant. Although I understand that MHS Cheerleading will make rea

Once you login to the Team Xplosion website with your SportsEngine Account info, click "Become A Member" in the top left corner, if the button appears. If.

Compe ve Club Soccer: U13– Pres ... EBAL All League (9th & 10th grade). Star ng forward ... 98 ODP Pacific Coast Invita onal - Ventura, CA. (US Soccer ID Na ...

U11 – U09 Alliance FC. High School Soccer: 2013 - 2012 Varsity James Logan High School. US Club Soccer Achievements: 2012 PDP G98 State Team Pool.

I acknowledge that all programs of ACE including, but not limited to cheerleading, dance, tumbling and fitness classes, team training, practices, performances ...