Registration Form

Athlete Tryout Application
Athlete Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Athletes Date of Birth*

MonthDayYear
Date
Name of School 2023-2024*
How many years experience does the athlete have in Cheerleading? *
How many years experience does the athlete have in Gymnastics?*
Has the athlete been involved in an All-Star Cheerleading program?*
If yes? What team?*
PARENT/GUARDIAN INFORMATION
Parent/ Guardian Name*

First NameLast Name
Parent/ Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/ Guardian Cell Phone Number*
Please enter a valid phone number.
Parent/ Guardian Email Address*
example@example.com
EMERGENCY CONTACT
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship*
ALLERGIES/ MEDICAL
Please list any health conditions that we may need to be made aware of*
Does athlete use inhaler?*
When was athletes last physical? *

MonthDayYear
Date
PARENT/ GUARDIAN CONSENT
In consideration of "Self" or "My Child"(hereinafter referred to as the “Minor”) being permitted by Dynasty Athletics LLC DBA Dynasty Xtreme Allstars to participate in its activities and to use its equipment and facilities, or other facilities used by Dynasty Athletics LLC DBA Dynasty Xtreme Allstars, I further agree to indemnify and hold Dynasty Athletics LLC DBA Dynasty Xtreme Allstars, as well as any other facilities used, from any and all claims which are brought by, or on behalf of the Minor and which are in any way connected with such use or participation by the Minor.

In case of an emergency, I grant permission to Dynasty Athletics LLC DBA Dynasty Xtreme Allstars and its personnel, to have authority, at my expense, in the event I cannot be reached, to utilize the most convenient volunteer rescue squad vehicle or ambulance to transport the Minor and/or myself to the hospital and if necessary, I authorize medical treatment. I verify that the Minor and/or myself have passed a medical examination within the last twelve months and are capable of participating in cheerleading, gymnastics, dance and related activities.

I acknowledge that if anyone is hurt, or property is damaged during my participation or the participation of the Minor in this activity, I and/or the Minor may be found by court of law to have waived the right to maintain a lawsuit against Dynasty Athletics LLC DBA Dynasty Xtreme Allstars on the basis of any claim from which I have released Dynasty Athletics LLC DBA Dynasty Xtreme Allstars either personally and/or as the parent, natural guardian and/or legal guardian of the Minor by signing this Agreement.

I, understand in the event I (minor) am not able to attend the event no refund will be issued due to all sales final

I, the undersigned Parent/Guardian/Athlete do hereby give consent for the above athlete to participate in the training and activities held at Dynasty Athletics LLC DBA Dynasty Xtreme Allstars. and accept responsibility for all costs incurred by myself or my athlete. I have completely filled out this form in its entirety and attest that all information given is factual.
How were you referred to us?*
Signature*

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Date*

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Date
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Athlete Tryout Application

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT

ALLERGIES/ MEDICAL

PARENT/ GUARDIAN CONSENT