Battler CATS Registration Form

Full Name*

First NameLast Name

Age*

Birthday*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Billing E-mail *

example@example.com

Are there any physical, medical, or other conditions we should know about prior to training your athlete:

Current Squad(s) School/All stars/ Pop warner

Parent*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Parent

First NameLast Name

Phone Number

Please enter a valid phone number.

Release and Waiver

I the undersigned (if applicant is 18 years or older) or parent/guardian of above listed minor applicant/participant acknowledge and fully understand that each applicant/participant will be engaging in activities that involve risk of serious inury, including permanent disability or death, and severe social and economic losses which might result not only from their own actions, in actions or negligence, but action, in action or negligence of others, the condition of the premises or of any equipment used or unknown risks/situations not reasonably foreseeable at this time. I the undersigned (if applicant is 18 or older) or parent or guardian assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death, hereby release, discharge, covenants to indemnify and not sue Battler CATS LLC, its affiliated organizations and sponsors, their coaches, and associated personnel, including Battler's Knob LLC or any premises used to conduct the event, all of the next of kin for any and all against any claim by or on behalf of the applicant as a result of the applicants participation in the programs of gymnastics/cheerleading/acrobatics lessons or any program or activities of Battler CATS LLC and or being transported to or from the same, which participation after careful consideration, I hereby authorize, and which transportation I hereby authorize.

The applicant/participant has received a physical examination by a physician and has been found physically capable of participating in the sport of Cheerleading/Gymnastics and has been found physically capable of participating in Tumbling and other gym activities. I hereby give my consent to have an athletic trainer, coach, and/or doctor of medicine or dentistry or associated personnel to provide the applicant/participant with medical assistance and /or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I also agree to save and hold harmless and indemnify each and all parties herein referred to above as release from all liability, loss, cose, claim, or damage whatsoever, including death or damage to property which may be imposed upon said release because of any defect in or lack of suck capacity to so act or caused or alleged to be caused in whole or in part by the negligence of the release. I have read the above waiver/release and sign below voluntarily.

I the undersigned (if applicant is 18 years or older) or parent/guardian of above listed minor applicant/participant acknowledge and agree that I am the parent or legal guardian of the above named minor and therefore have the authority to grant these permissions.

Signature*