Cheerleading Registration Form
Price includes T-shirt and Pom Pom's
Date Today
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Month
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Day
Year
Date
Player/Child Information:
Player 1 Name
*
First Name
Last Name
Player 1 Date of Birth
*
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Year
Grade as of 2023-2024 school year
Please Select
3rd
4th
5th
T-Shirt Size
Please Select
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Player 1 Ethnicity **Information provided will be used for grant opportunities in the future.
American Indian or Alaska Native
Hispanic
Asian
Black or African American
White
Prefer not to answer
Player 1 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Emergency Contact Information
Name of Emergency Contact
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Relation to Athlete
*
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Next
Checkout Selection
*
prev
next
( X )
Number of Registered Players
$
30.00
Select if registering 1 player/child.
Quantity
1
2
3
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Parental/Guardian Consent
Waiver
I am fully aware that this sport activity may cause accidental injury to athletes. I likewise assume any and all possible risk that may cause injury, illness, or death arising to such activity. I hereby declare that I waive my right to pursue any and all claims against the Commission and the Organizing Committee of this event should in any case that the accident, injury, illness or death occurs in the course of any activity held by them.
Name
*
First Name
Last Name
Date Signed
*
-
Month
-
Day
Year
Date
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