Athlete Intake and Program Waiver Form

Athlete Intake Form

Fields marked with an asterisk are required.
Athlete Name (First Name, Middle Initial, Last Name):

First NameLast Name
Age:
Birthday (Month/Date/Year):

MonthDayYear
Date
Address (City/Zip Code:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name:

First NameLast Name
Parent/Guardian Phone:
Format: (000) 000-0000.
Parent's E-mail:
example@example.com
Emergency Contact Name:

First NameLast Name
Emergency Phone:
Format: (000) 000-0000.
Health Insurance Company /Policy #
Allergies/Health Problems/Medications (Please describe in detail):
Medical Release I hereby certify that I understand and agree to the following:
1. Dance and cheerleading involves a variety of movement, motions, rotations, leaps, tumbling, jumps, partner stunts and pyramids, therefore, participation in these athletic activities involves some amount of inherent danger and risk of personal injury.
2. I hereby assume all risks involved with the above registered participant participating in these dance and cheerleading activities. I realize and acknowledge that improper or proper conduct during the athletic activity could result in catastrophic injury, paralysis, or even death.
3. I hereby agree to indemnify and hold harmless Hive Cheer & Dance and all Hive Cheer & Dance staff and vendors for any injury that the above named participant may incur while participating in Hive Cheer & Dance programs.
4. My son/daughter is a volunteer participant in the training that Hive Cheer & Dance provides. My son/daughter will only partake in this training under the direct supervision of a Hive Cheer & Dance instructional staff member.
5. In the event that Hive Cheer & Dance uses facilities other than their own and an accident or injury should happen, I hereby agree not hold liable the facility, company, organization, proprietor, or its employees of the location that Hive Cheer and Dance is utilizing.
6. I am aware as a parent/ guardian of the above-named participant, that I will be responsible for providing proper insurance coverage and insurance information to Hive Cheer & Dance prior to the participation of any Cheer & Dance training.
Type initials in this box to agree with terms listed above
Appearance Clause
Permission is granted to use my daughter/son picture or image in future advertisements, literature, and social media for the Hive Cheer & Dance program.
Type initials in this box to agree with terms listed above
Hive Cheer & Dance Participant Registration Agreement -
I HAVE CAREFULLY READ THIS DOCUMENT AND I UNDERSTAND AND ACCEPT THE INFORMATION AND REQUIREMENTS THEREIN.
Parent Signature
Date

MonthDayYear
Date

WAIVER/RELEASE FORM

Fields marked with an asterisk are required.
In consideration of my minor child/ward, being allowed to participate in the Hive Cheer and Dance, related events and activities, the undersigned acknowledges and agrees to the following: I realize that cheerleading is a vigorous physical activity that involves running, jumping, kicking, lifting and rotation; coordinated body movements (tumbling, gymnastic skills, etc.). I understand that participation in cheerleading involves certain inherent risks and that regardless of the precautions taken by Hive Cheer and Dance or the participants some injuries may occur. These injuries include but are not limited to:

1. Sprains, strained muscles

2. Broken bones, dislocated joints

3. Permanent disability

4. Quadriplegia

These injuries may result from hazards such as but not limited to:

1. Stepping on uneven ground

2. Falling or being dropped

Adhering to the following safety rules may lessen the likelihood of such injuries:

1. Wear gymnastics uniform provided ONLY

2. Wear cheer shoes (no sandals or flip flops)

3. Keep hair off shoulder (wear in pony tail, pigtails, etc)

4. Do not wear jewelry (earrings, rings, bracelets, necklaces, etc)

5. Properly warm up before practices and performances

6. No stunting or flipping without a coach or adult present

7. No "horseplay" during practices or performances

8. Stay in the designated cheerleading area

I agree to comply with the Hive Cheer and Dance stated and customary terms and conditions for participation. In order to properly protect my own child's safety and that of fellow participants, I agree to follow these rules as well as any others that may be given by my child's coach, official, sponsor or any other agent of Hive Cheer and Dance.

Further, in recognition of the importance of shared responsibility for safety, I will remove my child and immediately report any noted deviations from the safety rules as well as any observed hazardous conditions or equipment to the coach, official, sponsor or agent of Hive Cheer and Dance.

I HAVE CAREFULLY READ THE FOREGOING DOCUMENT. I HAVE HAD THE OPPORTUNITY TO ASK QUESTIONS AND HAVE THEM ANSWERED. I AM CONFIDENT THAT I FULLY KNOW, UNDERSTAND, AND APPRECIATE THE RISKS INVOLVED IN ACTIVE PARTICIPATION IN CHEERLEADING.

HAVING BEEN INFORMED of the above program, I, the parent of the above-named registrant, do hereby give my approval of his/her participation in any and all of the activities during the current season. I ASSUME ALL THE RISKS AND HAZARDS INCIDENTAL TO THE CONDUCT OF THE ACTIVITIES, and I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, do further RELEASE, ABSOLVE, INDEMNIFY, AND HOLD HARMLESS the Hive Cheer and Dance, the organizers, sponsors, supervisors, volunteers, other participants, advertisers, officials, and, if applicable, owners and lessors of premises used to conduct practices or games, any or all of them.

In case of injury to my son/daughter, I HEREBY WAIVE ALL CLAIMS against the organizers, the sponsors, or any of the supervisors appointed by them. I am voluntarily requesting permission for my son/daughter to participate.
Parent/Guardian Signature
Parent Name
Should be Empty:

Athlete Intake Form

Medical Release I hereby certify that I understand and agree to the following:

Appearance Clause

Hive Cheer & Dance Participant Registration Agreement -

WAIVER/RELEASE FORM