SSCC Cheer Clinic Registration Form

Cheerleader's Name

First NameMiddle NameLast Name

Birth Date

MonthDayYear

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian E-mail

example@example.com

Mobile Number

Home Phone Number

Parent/Guardian Name

First NameLast Name

Cheerleader Tshirt Size needed asap

(Specify Children's or Adult Size)

Once Registration for Clinic has been received, we will be in contact with you for payment of $35

Please make sure your child wears comfortable gym shorts, form fitting tshirt, soft soled sneakers (if you have cheer sneakers, they are perfect) with socks, hair up in high ponytail with all hair off face, bottle of water to bring. No jewelry or watches on. They are more than welcome to bring a snack, however there will be some snacks availabe at the clinic.

Let's Cheer!!

Is this your child's first time doing cheer?

Informed Consent and Acknowledgement - I hereby give my approval for my child’s participation in any and all activities prepared by Stafford Sparklers Inc., aka SSCC during any practice, clinic, competition, event. In exchange for the acceptance of said child’s candidacy by Stafford Sparklers Inc., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Stafford Sparklers Inc. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected Stafford Sparklers Inc. sessions, practices, clinics, competitions, etc. In case of injury to said child, I hereby waive all claims against Stafford Sparklers Inc. including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being seriously injured that is inherent in all sports activities, including cheerleading. Medical Release and Authorization - As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the {Organization} . and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

My Products

Registration Fee

$45.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Signature of Parent or Guardian

Clear

Thank you! Looking forward to the upcoming SSCC Clinic!

Athlete Registration Form

Payment Methods