SJC All Stars

SJC All Stars

34 West Broadway, 2nd Floor, (rear entrance) Hanover, PA 17331
Athlete Information
Full Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birthdate

MonthDayYear
Date
School you attend:
Grade:
I authorize SJC All Stars to use my child's image and/or likeness in official media, including: Our Facebook, promo material, newsletters and related media.*

YesNo
PARENT/GUARDIAN #1
Full Name:*

First NameLast Name
E-mail:
Home Phone:*

Area CodePhone Number
Cell Phone:

Area CodePhone Number
PARENT/GUARDIAN #2
Full Name:

First NameLast Name
E-mail:
Home Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
EMERGENCY CONTACT INFORMATION
Full Name:*

First NameLast Name
Relationship to Athlete:
Home Phone:*

Area CodePhone Number
Cell Phone:

Area CodePhone Number
WAIVER INFORMATION
I hereby grant permission to allow my child to participate in athletic activities, as sponsored by SJC All Stars, Inc..

Furthermore, I hereby release SJC All Stars, Inc., it’s officers, agents, and coaches from any legal or financial responsibility resulting from actions of, or injury to my child while engaged in any or all of these sponsored activities (i.e. practices, games, competitions). It is my understanding that every registered participant will be covered by accident insurance.

I also certify that my child has NO HEALTH OR PHYSICAL IMPAIRMENTS which will hamper his/her ability to perform as a Cheerleader or cause his/her participation to be unsafe to themselves or other participants. If there are any health/physical problems SJC All Stars, Inc. should be aware of please indicate below:
I/We agree with the above*

YesNo
Health/Physical Limitations (if any):
Insurance Carrier:
Policy#:
I agree

I understand that if my child is running a temperature above 100.3, or is experiencing Covid or Flu symptoms, he/she will not be permitted to participate in any class until fever free for at least 24 hours and symptoms have improved. I will refrain from bringing my child to practice if he/she displays signs of illness or fever.
I agree

I understand my child may be in close and/or physical contact with other athletes during all classes. I understand, while precautions will be taken to reduce the risk of my child contracting the Covid-19 virus, there is no guarantee infection will not occur. I accept responsibility for my child’s participation in classes, and I release SJC All Stars of any and all liability pertaining to Covid 19 risks associated with close contact with other athletes.
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SJC All Stars

Athlete Information

PARENT/GUARDIAN #1

PARENT/GUARDIAN #2

EMERGENCY CONTACT INFORMATION

WAIVER INFORMATION