2023-2024 The Cheer Squad, Inc.
Cheerleading Assessment Registration Form
WAIVER INFORMATION
My child, listed below in the applicant section of this form, has my permission to be a cheerleader at The Cheer Squad Inc. I understand that he/she must abide by the rules and regulations set forth by the advisor and the principal of The Cheer Squad Inc., and be present for all practices and games. I have read the rules and regulations and understand that the violation of any of these rules may lead to temporary or permanent suspension from the squad. I understand and give permission for my daughter/son to ride with the advisor and/or other parents when necessary. I understand that all forms attached must be completed by February 11th, or my child will not be allowed to be assessed. I understand that my daughter/son will be evaluated by qualified coaches, and we abide by the their selections. I understand all costs involved as stated in the “Fee Sheet” I understand by the very nature of the activity, cheerleading & dance carry a risk of physical injury. No matter how careful the participant and coach are, how many spotters are used, or what landing surface is used, the risk cannot be eliminated. The risk of injury includes minor injuries such as muscle pulls, dislocation, and broken bones. The risk also includes catastrophic injuries such as permanent paralysis or even death from landing or falls on the back, neck, or head. I understand these risks and will not hold The Cheer Squad, Inc. or any of its personnel responsible in the case of accident or injury at any time.
I/We agree with the above
*
Yes
No
Signature
WAIVER INFORMATION
I am interested in being a cheerleader at The Cheer Squad, Inc. I understand the risks stated above. If elected, I promise to abide by the rules and regulations set forth by the advisory board the program director of The Cheer Squad, Inc. I promise to cooperate and follow the instructions of the cheerleading coaches.
I/We agree with the above
*
Yes
No
APPLICANT INFORMATION
Future Cheer Squad Cheerleader
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Full Name:
*
First Name
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home Phone:
*
-
Area Code
Phone Number
DATE OF BIRTH:
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
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11
12
13
14
15
16
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24
25
26
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28
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30
31
Day
Please select a year
2040
2039
2038
2037
2036
2035
2034
2033
2032
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2029
2028
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2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
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1975
1974
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1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
Year
Gender:
*
Please Select
Male
Female
PARENT/GUARDIAN
Full Name:
*
First Name
Last Name
Home Phone:
-
Area Code
Phone Number
Cell Phone:
*
-
Area Code
Phone Number
E-mail:
*
School now attending 24-25:
*
Current Grade Level 24-25
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Team Selection
*
Recreational Cheer
Recreational Dance
Elite Cheer
Elite Dance
Majorette Pom
Step
Previous cheer experience
*
Yes
No
Previous dance experience
*
Yes
No
STUNTING experience
*
Base
Main Base
Back Spot
Flyer
None
Why do you want to become a member of The Cheer Squad Cheerleader?
What does commitment mean to you?
Are you committed to cheering for both Rec. and “Elite”season?
Pittsburg Cheer is a year round program (Football and Basketball)
What are you willing to contribute to The Cheer Squad, Inc. Team?
What are you looking to get from being a Cheer Squad Inc. Cheerleader?
What are your strengths?
What are your weaknesses?
What areas are you most stronger in when it comes to cheer and dance?
What makes a good cheerleader?
What makes a good coach?
Are you interested in being a cheer captain?
Are you interested in being a part of the competition team?
Anything more that you would like to add?
Comments or Questions
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Cheer Assessment Fee
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
For more payment options please click the following link:
https://square.link/u/bqXhJxPV?src=sheet
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