Revive Cheer Athletics Registration Form

Season 24-25 Registration
Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Athlete Birth Certificate

Revive Cheer Athletics requires a copy of the athlete's birth certificate to be kept on file.
File Upload

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Athlete Age*
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Athlete Shirt Size*
Does your athlete have previous cheer experience? If yes, please list how many years, what level teams, and tumbling. *
Parent/Guardian Information
Name*

First NameLast Name
Home Number*
Cell Number*
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Alt. Phone Number
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the athlete prescribed an inhaler? If yes, please explain any instructions.*
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Revive Cheer Athletics during the season. In exchange for the acceptance of said child’s candidacy by Revive Cheer Athletics, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Revive Cheer Athletics. and all its respective officers, agents, and representatives from any and all liability for injuries.

In case of injury to said child, I hereby waive all claims against Revive Cheer Athletics. 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 injured that is inherent in all sports activities.
Do you authorize your athlete to receive medical treatment while at Revive Cheer Athletics?*

YesNo
If yes, please select the medications below that may be given to your athlete.*

Antibiotic ointmentAlcohol wipesBenadryl Cream
Athlete Sports Physical

Revive Cheer Athletics requires an up to date (May 2024) sports physical on file to begin practice.
File Upload

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Media Release

Photos and videos will be posted throughout the season on all social media platforms and other public platforms of athletes during practice, competitions, Revive events, etc. without consent from athletes/parents.
Media Release Consent*

By checking this box, I acknowledge and give Revive Cheer Athletics permission to use any photo/media content of my athlete.
Financial Agreement

I agree and understand I am financially responsible for monthly tuition payments that are due the first of every month. I agree and understand I am financially responsible for camp fees, competition fees, coach's fees, required uniform/apparel, or other items/classes purchased. I agree and understand that I am financially responsible for all travel expenses for my athlete and family. I understand that if payments are late, a 10% late fee will be added, and my athlete may be suspended until paid in full. All teams are a season long commitment. If an athlete leaves the team midseason, a drop out fee of $500 will be charged. No refunds will be issued for competition fees, apparel on order, or monthly tuition, etc. Past due or any existing open invoices will remain your financial responsibility in the situation your athlete becomes injured, is dismissed from the program, or choses to leave the program. Revive Cheer Athletics has the legal right to turn any delinquent account balances over to a collection agency.
Financial Policy*

By checking this box, I acknowledge and agree.
Attendance Policy

Athletes are allowed 5 absences for the 24-25 season, unless approved by Revive Coaches. If you must miss practice due to an illness, a doctor’s note will be required to be excused. Practices are mandatory two weeks prior to any program events or competitions. Additional practices may be added throughout the season as needed. An athlete may be removed from the team for attendance conflicts.
Attendance Policy*

By checking this box, I acknowledge and agree.
REVIVE CHEER ATHLETICS COMPLETE POLICY AGREEMENT

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE. BY SIGNING BELOW, I UNDERSTAND AND AGREE WITH ALL OF THE INFORMATION AND TERMS OF REVIVE CHEER ATHLETICS POLICIES.
Signature*

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Date*

MonthDayYear
Date
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