2026-27 ATHLETE WAIVER

2026-27 ATHLETE WAIVER

Complete this waiver for Connect Cheer NW’s 2026–2027 season. All required athlete, parent/guardian, emergency, and medical information, as well as acknowledgments and signatures, must be provided.
Athlete First Name
Athlete Last Name
Date of Birth

MonthDayYear
Date
Grade (2026–2027)
School Attending
Home Address
City
State
Zip Code
Athlete Email
example@example.com
Athlete Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Primary Parent/Guardian Name
Primary Parent/Guardian Email
example@example.com
Primary Parent/Guardian Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Parent/Guardian Name
Secondary Parent/Guardian Email
example@example.com
Secondary Parent/Guardian Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Athlete Resides With
Emergency Contact Name
Relationship to Athlete
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Family Doctor
Doctor Phone
Please enter a valid phone number.Format: (000) 000-0000.
Insurance Company
Policy Number
Preferred Hospital
Past injuries or broken bones
Date of last physical exam

MonthDayYear
Date
Current medications
Medical conditions (heart, asthma, diabetes, etc.)
Allergies
If yes, allergic to
Additional medical information
Parent/Guardian Printed Name
Relationship to Athlete (Acknowledgment Section)
Date (Acknowledgment Section)

MonthDayYear
Date
Athlete Name (Acknowledgment Section)
ASSUMPTION OF RISK & LIABILITY WAIVER:

Cheerleading, tumbling, stunting, conditioning, and all related gym activities involve inherent and unavoidable risks, including but not limited to sprains, strains, fractures, concussions, falls, collisions, equipment-related injuries, and exposure to illness or communicable diseases. These risks cannot be eliminated without fundamentally altering the nature of the activities.

By signing below, I acknowledge and agree that:

• My athlete is participating voluntarily.

• I understand the inherent risks associated with these activities.

• I accept full responsibility for my athlete’s participation. To the fullest extent allowed by Washington State law, I release, waive, and hold harmless Connect Cheer NW, its owners, directors, employees, contractors, and volunteers from any claims arising from ordinary negligence. I understand that this waiver does not release claims related to gross negligence or willful misconduct, which cannot legally be waived in Washington.

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MEDICAL AUTHORIZATION:

If my athlete becomes injured or ill and I cannot be reached, I authorize Connect Cheer NW to obtain emergency medical treatment on my behalf. I accept full financial responsibility for any medical care provided. I agree to notify Connect Cheer NW of any changes to my athlete’s medical condition during the season.

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MEDIA RELEASE:

I give Connect Cheer NW permission to photograph or record my athlete and to use these images for team updates, social media, promotional materials, and gym communication. I understand that images may be used without additional approval and that no compensation is provided.

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ELECTRONIC SIGNATURE CONSENT:

By signing electronically, I agree that my electronic signature is the legal equivalent of my handwritten signature and is valid for all purposes related to this waiver.

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ACKNOWLEDGMENT & SIGNATURE

Parent/Guardian Printed Name:{q35_textbox33}

Relationship to Athlete:{q21_textbox19}

Date:{q37_datetime35}

Parent/Guardian Signature:{q38_signature36}

Athlete Name:{q39_textbox37}
Parent/Guardian Signature
Should be Empty: