Florida Top Dog All-Stars 2022–2023 Tryout Packet Application

2022–2023 • FL Top Dog All-Stars

TRYOUT PACKET APPLICATION

___________________________

ATHLETE INFO

ATHLETE NAME: *

Last Name First Name

ATHLETE: Birth Date *

Birth Date

ATHLETE: Cell Number (if applicable) *

Athlete Cell Number ONLY! — (Enter 000-000-0000, if not applicable)

ATHLETE: Email *

Athlete Email ONLY! — (Enter na@notapplicable, if not applicable)

ATHLETE: School (2022–2023) *

School Name

ATHLETE: Grade (2022–2023) *

Select the Grade Athlete will be in for the 2022–2023 school year.

___________________________

PRIMARY CONTACT INFO

PRIMARY CONTACT NAME: *

Last Name First Name

PRIMARY CONTACT: Relation to Athlete *

Select Primary Contact's relation to the Athlete.

PRIMARY CONTACT: Cell Number *

Enter Primary Contact's cell number.

PRIMARY CONTACT: Email *

Enter Primary Contact's email.

___________________________

SECONDARY CONTACT INFO

SECONDARY CONTACT NAME: *

Last Name or (Enter N/A, if not applicable) First Name or (Enter N/A, if not applicable)

SECONDARY CONTACT: Relation to Athlete *

Select Secondary Contact's relation to Athlete. — (Select N/A, if not applicable)

SECONDARY CONTACT: Cell Number *

Enter Secondary Contact's cell number. — (Enter 000-000-0000, if not applicable)

SECONDARY CONTACT: Email *

Enter Secondary Contact's email. — (Enter na@notapplicable, if not applicable)

___________________________

PERSONAL INFORMATION

1. Are you currently or planning to be a member of any club or team that requires practice time? *

Yes No

(If Yes, please list below — if No, enter N/A below) *

2. Please check the following that you are experienced in. (Please check all that apply) *

Main Base Flyer Side Base Tumbling Back Base No Experience

3. If you are a flyer, what is of more importance? (Please check one of the following that apply) *

Being on a team that is leveled to your overall skill. Being on a team where you would have a better chance of flying even if it meant being on a lower level team.

(Please check all that apply) *

I would like to be considered as a cross competitor for a second team and can pay the additional fees if selected. (approximate cost is $700) I am from Largo and only want to be considered for a Largo Top Dog Team. I am from Largo and would be willing to do a team that practices in Lakewood Ranch. I am from Lakewood Ranch and only want to be considered for a Lakewood Ranch Top Dog Team. I am from Lakewood Ranch and would be willing to do a team that practices in Largo. Iwould be willing to do a team that is half in Largo and half in LWR. I would like to be considered for a Novice team only. I would like to be considered for a Prep team only. I agree to uphold the standards in this packet if I am selected to cheer for the Florida Top Dog All-Stars.

5. What years have you cheered for Florida Top Dog All-Stars? (Please check all that apply) *

ATHLETE: Signature *

Athlete's Signature Clear

Today's Date *

Today's Date

ATHLETE NAME: *

Last Name First Name

___________________________

PARENT / GUARDIAN

COMMITMENT

My son/daughter, *

Athlete's Last Name Athlete's First Name

is trying out for the Florida Top Dog All-Star Program. If he/she makes a team, I commit myself to the following:

I will provide transportation to and from practices, fundraisers, and other activities.
I will provide transportation and/or lodging for competitions.
I will call the coaches when my son/daughter will be absent from a cheerleading activity.
I will schedule all family vacations so they will not conflict with the cheerleading activities having been given the cheerleading schedule in advance. I understand the importance of this sacrificial commitment and how it affects the entire team.
I understand a coach has the right to suspend or dismiss my child from a competition/team if he/she violates the athlete promise or Top Dog Constitution.
I understand that my child may be moved to a different team during the course of the season if there is a change in his/her skill level. I agree to pay any difference of fees if applicable.
I agree to encourage my son/daughter to uphold the standards and guidelines set forth in the Top Dog Constitution.
I agree to bring ALL complaints directly to the coaches and will refrain from discussing problem matters with other parents or athletes. I understand that discussing complaints among parents can affect the morale of the team.
I understand that my actions could affect my child's position in the Top Dog program including removal if I do not abide by the parent commitment contract that I have signed.
I have read and fully understand all of the material included in this packet

FINANCIAL COMMITMENT

I have read the policies in regard to the financial obligation and fully understand these policies. I understand that my commitment is for the 2022-2023 competitive season. I understand that I am giving my credit card/debit card information and that information to be used for payments to Florida Top Dog All-Stars. I will inform the Top Dog office if my credit/debit card information changes. I understand that I will be given the opportunity to raise a portion of these funds through fundraising and all monies turned in become the property of Top Dog All-Stars and will not be refunded if my child quits, is dismissed, or has to leave the team for any reason. I understand that I am entering into this program of my own free will.

1st Parent / Primary Contact / Guardian: Signature *

1st Parent / Primary Contact / Guardian's Signature Clear

Today's Date *

Today's Date

1st Parent / Primary Contact / Guardian Name: *

Last Name First Name

1st Parent / Primary Contact / Guardian: Relation to Athlete *

Select 1st Parent / Primary Contact / Guardian's relation to Athlete.

2nd Parent / Secondary Contact / Guardian: Signature *

Sign N/A, if not applicable Clear

Today's Date *

Today's Date

2nd Parent / Secondary Contact / Guardian Name: *

Last Name or (Enter N/A, if not applicable) First Name or (Enter N/A, if not applicable)

2nd Parent / Secondary Contact / Guardian: Relation to Athlete *

Select 2nd Parent / Secondary Contact / Guardian's relation to Athlete. — (Select N/A, if not applicable)

___________________________

LARGO

ACKNOWLEDGEMENT OF RISK—WAIVER OF LIABILITY—INDEMNIFICATION & CONSENT

As legal guardian of, *

Athlete's Last Name Athlete's First Name

I hereby consent to the aforementioned person participating in Florida Top Dog All-Stars, Inc., (hereinafter referred to as “Top Dog’’) programs, including, but not limited to, competition and practice. I recognize that potentially severe injuries can occur in any activity involving height and/or motion, including tumbling, stunting, jumping, cheerleading, and other related activities, including trampoline and dance. It is recommended that a physical be performed by a medical doctor prior to participation in the aforementioned enumerated activities for the child’s benefit. By virtue of the execution of this document, I hereby affirmatively state that my child is physically able to participate in any and all Top Dog activities.

NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN:

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF JUST TUMBLIN’ USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM JUST TUMBLIN’ IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND JUST TUMBLIN’ HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

In consideration for allowing my child to use the facilities identified as the Just Tumblin’ gym, as well as other locations, where cheerleading competition and/or exhibitions may occur, I hereby forever release Top Dog, a not-for-profit entity, its employees, instructors, coaches, agents, and any other volunteers, from any and all liability, for any and all damages and/or injuries, suffered by my child while under the instruction, supervision, or control, direct or indirect, of Top Dog, its employees, instructors, coaches, and agents, and any and all other volunteers, whether caused by their own negligence or otherwise.

As legal guardian of the aforementioned person, I herby acknowledge that it is my sole responsibility to provide for any medical expenses or other attendant costs which may be incurred by my child as a result of any injury sustained while under the instruction of Top Dog, its employees, instructors, coaches, agents, and any and all other volunteers. In recognition of the execution of this Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent, I further agree to indemnify Just Tumblin’, its employees, instructors, coaches, agents, and any and all other individuals acting on behalf of an of the aforementioned individuals or entities, from any claim for damage or injury of said child, including reasonable attorney’s fees incurred in defending any such claim.

This Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent, having been read and understood completely, is signed voluntarily as to its content and intent. This Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent shall continue in full force and effect until such time as revoked, in writing, by the undersigned, without limitation as to its duration, as it is acknowledged and understood that my child shall participate in cheerleading and/or tumbling activities, including, but not limited to, practice, exhibitions, and other related activities, on an on-going basis.

The undersigned further acknowledge and agree that Top Dog shall be granted specific permission to use the image and/or likeness of the aforementioned child for any purpose as deemed applicable by Top Dog, including photographs and/or videotape, and to further use said child’s name, face, likeness, voice, and appearance in connection with exhibits, publicity, advertising, and promotional materials without reservation or limitation as to the duration of the consent.

The undersigned expressly agrees that this Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent is intended to be as broad and inclusive as permitted by the laws of the State of Florida, and that if any portion of this document is held invalid, it is agreed that the balance shall, notwithstanding, continue, in full legal force and effect. The undersigned further acknowledges that he/she is authorized to execute this Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent on behalf of the child and the parents, guardian, legal representative, personal representative, assigns, heirs, and next of kin.

I authorize Top Dog to retain and rely upon any document executed including but not limited to the Release in electronic form and shall not challenge its authenticity in the event the original is destroyed after electronic preservation.

1st Parent / Primary Contact / Guardian: Signature *

1st Parent / Primary Contact / Guardian's Signature Clear

Today's Date *

Today's Date

1st Parent / Primary Contact / Guardian Name: *

Last Name First Name

1st Parent / Primary Contact / Guardian: Relation to Athlete *

Select 1st Parent / Primary Contact / Guardian's relation to Athlete

2nd Parent / Secondary Contact / Guardian: Signature *

Sign N/A, if not applicable Clear

Today's Date *

Today's Date

2nd Parent / Secondary Contact / Guardian Name:

Last Name or (Enter N/A, if not applicable) First Name or (Enter N/A, if not applicable)

2nd Parent / Secondary Contact / Guardian: Relation to Athlete *

Select 2nd Parent / Secondary Contact / Guardian's relation to Athlete. — (Select N/A, if not applicable)

___________________________

Just Tumblin'

ACKNOWLEDGEMENT OF RISK—WAIVER OF LIABILITY—INDEMNIFICATION & CONSENT

Aa legal guardian of, *

Athlete's Last Name Athlete's First Name

I hereby consent to the aforementioned person participating in Terrick Training,Inc., d/b/a Just Tumblin’ (hereinafter referred to as “Just Tumblin’”) programs, including, but not limited to, competition and practice. I recognize that potentially severe injuries can occur in any activity involving height and/or motion, including tumbling, stunting, jumping, cheerleading, and other related activities, including trampoline and dance. It is recommended that a physical be performed by a medical doctor prior to participation in the aforementioned enumerated activities for the child’s benefit. By virtue of the execution of this document, I hereby affirmatively state that my child is physically able to participate in any and all Just Tumblin’ activities.

NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN:

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF JUST TUMBLIN’ USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM JUST TUMBLIN’ IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND JUST TUMBLIN’ HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

In consideration for allowing my child to use the facilities identified as the Just Tumblin’ gym, as well as other locations, where cheerleading practice, competition, exhibitions, and any other use, as designated by Just Tumblin’ may occur, I hereby forever release Just Tumblin’, its employees, instructors, coaches, agents, and any other volunteers, from any and all liability, for any and all damages and/or injuries, suffered by my child while under the instruction, supervision, or control, direct or indirect, of Top Dog, its employees, instructors, coaches, and agents, and any and all other volunteers, whether caused by their own negligence or otherwise.

As legal guardian of the aforementioned person, I herby acknowledge that it is my sole responsibility to provide for any medical expenses or other attendant costs which may be incurred by my child as a result of any injury sustained while under the instruction of Just Tumblin’, its employees, instructors, coaches, agents, and any and all other volunteers. In recognition of the execution of this Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent, I further agree to indemnify Just Tumblin’, its employees, instructors, coaches, agents, and any and all other individuals acting on behalf of an of the aforementioned individuals or entities, from any claim for damage or injury of said child, including reasonable attorney’s fees incurred in defending any such claim.

This Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent, having been read and understood completely, is signed voluntarily as to its content and intent. This Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent shall continue in full force and effect until such time as revoked, in writing, by the undersigned, without limitation as to its duration, as it is acknowledged and understood that my child shall participate in cheerleading and/or tumbling activities, including, but not limited to, practice, exhibitions, and other related activities, on an on-going basis.

The undersigned further acknowledge and agree that Just Tumblin’ shall be granted specific permission to use the image and/or likeness of the aforementioned child for any purpose as deemed applicable by Just Tumblin’, including photographs and/or videotape, and to further use said child’s name, face, likeness, voice, and appearance in connection with exhibits, publicity, advertising, and promotional materials without reservation or limitation as to the duration of the consent.

The undersigned expressly agrees that this Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent is intended to be as broad and inclusive as permitted by the laws of the State of Florida, and that if any portion of this document is held invalid, it is agreed that the balance shall, notwithstanding, continue, in full legal force and effect. The undersigned further acknowledges that he/she is authorized to execute this Acknowledgment of Risk, Waiver of Liability, Indemnification, and Consent on behalf of the child and the parents, guardian, legal representative, personal representative, assigns, heirs, and next of kin.

I authorize Just Tumblin’ to retain and rely upon any document executed including but not limited to the Release in electronic form and shall not challenge its authenticity in the event the original is destroyed after electronic preservation.

1st Parent/Guardian: Signature *

1st Parent/Guardian's Signature Clear

Today's Date

1st Parent / Primary Contact / Guardian Name: *

Last Name First Name

1st Parent / Primary Contact / Guardian: Relation to Athlete *

Select 1st Parent / Primary Contact / Guardian's relation to Athlete

2nd Parent / Secondary Contact / Guardian: Signature *

Sign N/A, if not applicable Clear

Today's Date *

Today's Date

2nd Parent / Secondary Contact / Guardian Name: *

Last Name or (Enter N/A, if not applicable) First Name or (Enter N/A, if not applicable)

2nd Parent / Secondary Contact / Guardian: Relation to Athlete *

Select 2nd Parent / Secondary Contact / Guardian's relation to Athlete. — (Select N/A, if not applicable)

___________________________

LAKEWOOD RANCH

ACKNOWLEDGEMENT OF RISK—WAIVER OF LIABILITY—INDEMNIFICATION & CONSENT

I / we, *

Last Name — (1st Parent / Primary Contact / Guardian) First Name — (1st Parent / Primary Contact / Guardian)

*

Last Name — (2nd Parent / Secondary Contact / Guardian) First Name — (2nd Parent / Secondary Contact / Guardian)

and, as applicable, acting as parent, legal guardian, or custodian, on behalf of minor individual(s) (“Child” or “Children”) listed herein, for which I, the Undersigned, do hereby include as parties to this Waiver, intending them to be fully and legally bound by this Waiver, having the capacity and authority to agree to, acknowledge, consent, waive, and release or otherwise fully enter into this Waiver on their behalf as parent, legal guardian, or custodian:

ATHLETE NAME: *

Last Name First Name

ATHLETE: Age *

Athlete's Age

ATHLETE: Birth Date *

Athlete's Birth Date

(hereafter collectively referred to as the “Undersigned”, “I”, “Me”, “My”, “Mine”, or “Myself”), in consideration of the consent of the ownership and management of LAKEWOOD RANCH CHEERLEADING, LLC (“LWRC, LLC”) of 3115 Lakewood Ranch Blvd, Bradenton, FL 34211, its directors, officers, employees, agents, representatives, related entities, owners, successors, and the assignees of LWRC, LLC and any entities or persons located or operating therein, (hereinafter collectively referred to as “”LWRC”), to My use of any facilities, property, or equipment on the premises or in possession of LWRC (“LWRC Property”) installed at or in such facility (collectively, the “LWRC Facilities”), and to My participation in or observation of events or activities (hereinafter referred to as “LWRC Activities”), and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Undersigned, intending to be legally bound, for Myself, My heirs, assignees, executors, representatives, and administrators, does hereby acknowledge and do the following:

I, the Undersigned, voluntarily enter into this WAIVER OF LIABILITY AND GENERAL RELEASE (the “Waiver”), and do waive and release, assume all risks, and agree to indemnify and hold harmless LWRC, its directors, officers, employees, agents, representatives, related entities, owners, successors, and the assignees of LWRC from and against any and all claims for death, personal injuries, workers’ compensation, loss of property, property damage, and actions of any kind whatsoever, arising directly or indirectly out of or related to My use of or interaction with LWRC, LWRC Facilities and LWRC Property, or arising out of or related to My participation in or observation of LWRC Activities, including without limitation, liability arising out of any negligence, carelessness, action, omission, or conduct on the part of the LWRC.

LWRC PROPERTY, FACILITIES, AND EQUIPMENT

I understand, acknowledge, and agree that I am not authorized to use any LWRC Facility or LWRC Property, unless I have been so advised and permitted by LWRC, and have been advised sufficiently as to where I am and am not authorized to be. I also agree to comply with any verbal direction or instructions provided by LWRC as to such authorization, access, use, interaction, or observation.

Notwithstanding the aforementioned limitations, I understand and acknowledge that I may be asked to be an observer or limited participant within an area containing LWRC Property or a LWRC Facility which I am not permitted to use, but nevertheless may have need to be at or near, walk or stand on, touch, or interact with in order to comply with LWRC policies and procedures. I understand and acknowledge I am entirely voluntarily coming into contact with such property, equipment, or facility at My own risk. I further understand that LWRC is not and shall not be responsible for any injury that may occur due to My use or interaction with of the LWRC Facilities and LWRC Property. I further represent and warrant that I have sufficient health insurance to cover any and all injuries that I may sustain through use of or interaction with the LWRC Facilities or LWRC Property. I agree to be solely responsible for all such injuries, damages, loss, medical treatment, bills or otherwise that results from My use of or interaction with the LWRC Facilities and LWRC Property.

I acknowledge that I will use the LWRC Facilities and LWRC Property with reasonable and extraordinary care and take all precautions to minimize injury to Myself and others. I understand that it is My responsibility to immediately report any injury occurring as a result of the use of or interaction with the LWRC Facilities and LWRC Property to the LWRC. I shall also immediately report any problem, issue or dangerous condition existing or suspected of existing at the LWRC Facilities and LWRC Property. It is My responsible to inspect all equipment or LWRC Property or LWRC Facility prior to use or interaction.

Additionally, I expressly waive any right or claim that I may have now or that may rise in the future, arising out of or related to My use of the LWRC Facilities and LWRC Property, including, but not limited to, claims for insurance benefits, workers’ compensation coverage, personal injuries, death, property damages or loss, negligence claims, breach of contract, breach of warranty, breach of covenants, and any representation or warranty, whether such is express or implied.

I acknowledge the availability of instructions on the proper use of all LWRC Property and LWRC Facilities and represent that I will either read such instructions or get instruction from a qualified person prior to My use of or interaction with any LWRC Facility or LWRC Property. I shall only use or interact with such that I have complete understanding of its proper use, safety features, potential hazards, and warnings. I will not use any LWRC Facility or LWRC Property that I am not familiar with or that appears to be in disrepair. I further acknowledge that I understand all of the risks associated with use of the LWRC Facilities and LWRC Property and that I have received or been offered a copy of this Waiver and General Release. The use of the LWRC Facilities and LWRC Property and any and all equipment located therein is at My own risk and without liability to LWRC.

Further, if I choose to participate in any LWRC Activities, including but not limited to practices, trainings, conditioning, parties, games, cleaning, meets, observation of such, or any event whatsoever or whenever held at LWRC Facilities, using LWRC Property, or sponsored by or in conjunction with LWRC, I hereby waive and release, assume all risks, and agree to indemnify and hold harmless LWRC, its directors, officers, employees, agents, representatives, related entities, owners, successors, and the assignees of LWRC from and against any and all claims for death, personal injuries, workers’ compensation, loss of property, property damage, and actions of any kind whatsoever, arising directly or indirectly out of or related to My participation in such LWRC Activities, including without limitation liability arising out of any negligence, carelessness, action, omission, or conduct on the part of the LWRC.

Additionally, I expressly waive any right or claim that I may have now or that may arise in the future, arising out of or related to My participation in LWRC Activities, including, but not limited to, claims for insurance benefits, workers’ compensation coverage, personal injuries, death, property damages or loss, negligence claims, breach of contract, breach of warranty, breach of covenants, and any representation or warranty, whether such is express or implied.

I understand and agree that I am expressly waiving any and all rights under Florida law, and the laws of any state or territory of the United States, that would prevent or attempt to limit the application and enforceability of this Waiver and General Release. I am fully aware of all rights and remedies being released, as well as the potential claims and/or causes of action that I am waiving and releasing.

I acknowledge that I have read this Waiver and General Release in its entirety; I have had the opportunity to consult with My attorney to the extent I wish to do so; and I sign this Waiver and General Release willingly and with full knowledge and understanding of its legal effects, representing and acknowledging that I am of the age of majority, competent to understand this Waiver, and have the capacity as parent, legal guardian, or custodian to enter into this Waiver on behalf of the minor(s) herein listed.

1st Parent / Primary Contact / Guardian: Signature

1st Parent / Primary Contact / Guardian's Signature Clear

Today's Date *

Today's Date

1st Parent / Primary Contact / Guardian Name:

Last Name First Name

1st Parent / Primary Contact / Guardian: Relation to Athlete

Select 1st Parent / Primary Contact / Guardian's relation to Athlete.

2nd Parent / Secondary Contact / Guardian: Signature *

2nd Parent / Secondary Contact / Guardian's Signature Clear

Today's Date

2nd Parent / Secondary Contact / Guardian Name:

Last Name or (Enter N/A, if not applicable) First Name or (Enter N/A, if not applicable)

2nd Parent / Secondary Contact / Guardian: Relation to Athlete

Select 2nd Parent / Secondary Contact / Guardian's relation to Athlete. — (Select N/A, if not applicable)