CHEER: Drug Permission Form

1
Email* This field is required.
example@example.com
2
Athlete Name* This field is required.
First Name
Last Name
3
Date of Birth* This field is required.
Date
Month
Day
Year
4
TEAM NAME* This field is required.
Glimmer
Crystal
Sapphire
Mini Militia
Sparkle
Radiance
Cadets
J-OPS
Commanders
Sirens
5
Parent/Guardian Name* This field is required.
First Name
Last Name
6
Relationship to Athlete* This field is required.
7
Medication Name* This field is required.
8
Dosage & Frequency - any other specifics* This field is required.
9
The date we are authorized to administer* This field is required.
Date
Month
Day
Year
10

Important Reminders:

Competitions: The gym and team reps do not carry or provide over-the-counter medications. If your athlete needs medication during a competition, a parent must provide it directly to the team rep, along with a completed parent permission form.

Team reps will only distribute medication once they have confirmed the form is on file.

Practices: The gym does not distribute any medication during practices. Parents must handle all medication needs directly. This includes over-the-counter and prescription medications.

Exceptions: The only exception is for emergency medications, such as inhalers or EpiPens. These will be handled as needed in urgent situations.
Thank you for helping us keep all athletes safe and compliant with our policies.
11
SignaturePermission and Acknowledgement
Clear
Should be Empty: