504 Athletics – Parent/Guardian Consent Form

504 Athletics – Parent/Guardian Consent Form

Please complete this form to provide consent and necessary information for your child's participation.
2026-2027 TEAM ROSTER

SENIOR DIVISION:
• Purple Reign — Senior Level 1.1

MINI DIVISION:
• M2 — Mini Level 2.2 Prep

YOUTH NOVICE / COMPETITIVE NOVICE DIVISION:
• Violet — Youth Novice / Competitive Novice

YOUTH DIVISION:
• 4hantom — Youth Elite Level 4

Important Competition Day Notes:
• Elite teams (4hantom) will have two-day competitions throughout the season. Families must plan accordingly for both competition days.
• Prep/Novice teams (Purple Reign, Violet, M2) will have one competition day per event.
Athlete Information
Athlete's Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Age
Team Name
Season
Parent/Guardian Information
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Athlete
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Emergency Contact
Emergency Contact Name
Relationship to Athlete
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information
Known medical conditions?
If yes, please describe medical conditions
Any allergies?
If yes, please describe allergies
Current medications
Primary Care Physician Name
Physician Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Insurance Provider
Insurance Policy Number
Consent & Authorization
Consent to participate in all 504 Athletics practices, performances, and competitions
Authorize staff to seek emergency medical treatment if a parent/guardian cannot be reached
Grant permission for photos and videos to be used for promotional materials and social media
Understand cheerleading is physically demanding and acknowledge inherent risks
Agree to adhere to all 504 Athletics policies, codes of conduct, and financial obligations in the parent handbook
I understand that tuition is due on the 15th of each month and that a late payment fee of $25.00 will be applied to any payment received after the 25th.
Signature Section
Parent/Guardian Printed Name

First NameLast Name
Parent/Guardian Signature
Date

MonthDayYear
Date
Contract Agreements

Please read and acknowledge each agreement below.
PRACTICE POLICY & EXPECTATIONS

All athletes are expected to attend practices consistently and arrive prepared. Attendance and dress code are strictly enforced.
ATTENDANCE POLICY:
• Attendance is mandatory for all scheduled practices throughout the season.
• June – August: Athletes are allowed a maximum of 5 missed practices during this period.
• August – April: Athletes are allowed a maximum of 5 missed practices during this period.
• An Absence Request Form must be submitted through the 504 Athletics Portal/App no less than 2 weeks before the scheduled practice in order to be considered for approval.
• Absences not submitted through the portal/app at least 2 weeks in advance will be marked as unexcused.
• Athletes who exceed the allowed number of missed practices will be subject to a $25.00 fine per additional absence. This fine is non-negotiable and fully enforced.
• Any athlete who misses a practice within 2 weeks of a scheduled competition will be removed from that competition and placed on alternate status as needed. This is non-negotiable and is in place to protect the safety and integrity of the routine.
• All athletes must arrive to every practice in the full required practice uniform.
• Required practice attire includes: practice top, practice bottom, socks, and competition shoes.
• After August, team competition socks are required at every practice without exception.
• A bow is required at all practices.
• Any athlete arriving to practice missing any required uniform item will be subject to a $25.00 fee per occurrence.
• Competition makeup and competition hair are encouraged but optional for practices.
PRACTICE VIEWING POLICY
• All 504 Athletics practices are closed to parents and family members by default.
• Parents who feel the need to observe a practice must contact 504 Athletics at least 24 hours in advance to request approval.
• Any parent or guardian entering the 504 Athletics facility must abide by this contract in its entirety while on the premises.
• Parents may not sit on or lean against any gym equipment at any time.
• Parents may not coach, instruct, or direct their child from across the gym or any area of the facility, as this is disruptive to the coaching staff and the integrity of the practice environment.
• Failure to follow practice viewing guidelines may result in the parent/guardian being asked to leave and future viewing privileges being revoked.
GYM POLICY: - Absolutely no food of any kind is permitted inside the gym at any time — no exceptions. - Only clear liquids are allowed inside the gym. - Any parent or family member wishing to make a purchase from the Pro Shop must have an updated and current account in good standing with 504 Athletics. - All Pro Shop purchases are due in full at the time of purchase — no invoicing or payment plans for Pro Shop items.
I have read and agree to the Practice Policy & Expectations, including the attendance limits, absence request procedures, fines for excess absences, and practice dress code requirements.
Parent/Guardian Signature
Date

MonthDayYear
Date
Financial & Tuition Agreement
• ALL FEES ARE NON-REFUNDABLE.
• Monthly tuition is due on the 15th of each month.
• A late fee of $25.00 will be applied to any payment received after the 25th of the month.
• Returned/declined credit card payments through the auto payment portal will result in an immediate $25.00 fine.
• All tuition is all-inclusive with 4 payment options available. Once a payment option is chosen, it can only be modified with a $25.00 modification fee processed through the Financial Manager, Ms. Erica Coleman.
• Tuition payment option changes must be requested directly through the Financial Manager and are not self-service.
• No refunds will be issued for missed practices, competitions, or voluntary withdrawal from the program.
• Families who fall more than 60 days past due may be removed from the program without refund and will be charged the corresponding quit/removal fee per the Early Withdrawal / Quit and Removal Fee Agreement.
I have read and agree to the Financial & Tuition Agreement.
Parent/Guardian Signature
Date

MonthDayYear
Date
Athlete Code of Conduct
• Athletes are expected to demonstrate respect toward coaches, teammates, parents, and opposing teams at all times.
• Bullying, harassment, or disrespectful behavior — in person or on social media — will not be tolerated and may result in dismissal.
• Athletes must arrive to all practices and events on time and in proper attire.
• Excessive unexcused absences may result in removal from the routine or dismissal from the team.
• Athletes are responsible for maintaining academic eligibility and personal wellness.
• Unknown adults are not permitted around athletes at any time — athlete safety is the top priority.
• Any concerns should be communicated respectfully through proper channels (coach or program director), not on social media.
• Athletes are not permitted to take outside tumbling instruction from any coach or program unless written approval has been granted by 504 Athletics leadership. Unauthorized outside instruction may result in dismissal.
• Athletes and their families are held to the highest standard of conduct at all times at away and travel competitions, including but not limited to CheerSport and NCA. 504 Athletics representatives are expected to display professionalism, sportsmanship, and respect at every event regardless of location.
• Incorrect or inappropriate behavior reported by any coach, judge, venue staff, or fellow competitor at any event will result in immediate dismissal from the program with no refund, and an automatic contract withdrawal fee will be added to the account based on the time of dismissal per the Early Withdrawal / Quit and Removal Fee Agreement.
• Athletes are only permitted to be on one all-star cheerleading team at a time.
• Athletes may not participate in two all-star or recreational cheer programs within the same calendar year. Any athlete found to be participating in a competing program within the same calendar year will be subject to immediate removal from 504 Athletics, with no refund, and the applicable Early Withdrawal / Quit and Removal Fee will be added to the account.
I have read and agree to the Athlete Code of Conduct.
Parent/Guardian Signature
Date

MonthDayYear
Date
Media Release Agreement
• 504 Athletics may photograph and/or video record athletes during practices, performances, and competitions.
• Media may be used for promotional purposes including social media, the 504 Athletics website, and marketing materials.
• No compensation will be provided for use of likeness.
• Parents/guardians who do not wish to grant media rights must notify 504 Athletics in writing prior to the start of the season.
I have read and agree to the Media Release Agreement.
Parent/Guardian Signature
Date

MonthDayYear
Date
Uniform & Apparel Agreement
• Uniforms and team apparel are ordered at the start of each season and are non-refundable once ordered.
• Athletes are responsible for keeping uniforms clean, intact, and competition-ready.
• Lost or damaged uniforms must be replaced at the family's expense.
• Uniforms remain the property of 504 Athletics until all financial balances are cleared.
• Athletes must wear only approved 504 Athletics apparel at competitions unless otherwise instructed by coaches.
I have read and agree to the Uniform & Apparel Agreement.
Parent/Guardian Signature
Date

MonthDayYear
Date
Competition Commitment Agreement
• All athletes are required to attend every competition in full, from warm-up through the awards ceremony.
• Leaving a competition early — for any reason other than a documented medical emergency — is not permitted and is a violation of this agreement.
• Staying for awards is mandatory. Team placements, banners, and trophies are a collective achievement and all athletes must be present.
• Failure to stay for awards may result in suspension or removal from the team at the discretion of 504 Athletics leadership.
• Competition schedules will be communicated in advance; families are expected to plan accordingly.
I have read and agree to the Competition Commitment Agreement — including the requirement that all athletes stay through the awards ceremony at every competition.
Parent/Guardian Signature
Date

MonthDayYear
Date
TRAVEL COMPETITION POLICY

All athletes and families traveling for competitions are held to the highest standard of preparation, punctuality, and conduct.
ARRIVAL & CHECK-IN:
• All athletes attending travel competitions must check in and arrive at the designated meet-up location no less than 24 hours before the scheduled meet-up time.
• Failure to check in on time may result in the athlete being removed from the competition lineup.
• All athletes and families must stay through the full awards ceremony at every travel competition — no exceptions. (See Competition Commitment Agreement and the $100.00 fine for early departure.)

AWAY PRACTICE REQUIREMENTS:
• Athletes will have mandatory practice at travel competitions. All athletes must arrive at the designated practice location on time.
• Practice location details will be communicated in advance — families are responsible for knowing the location and planning accordingly.
• Practices at away competitions are mandatory and are treated with the same attendance standards as home practices. Missing an away practice is not excused.
• All athletes must wear full 504 Athletics practice gear for all away competition practices — this includes practice top, practice bottom, socks, competition shoes, and bow. No exceptions.

WEATHER & TRAFFIC POLICY:
• Families must be fully aware of and prepared for weather and traffic conditions during all away competitions.
• Neither weather nor traffic is an accepted excuse for late arrival to meet-up times, practices, or competition check-in.
• Families are expected to plan ahead and account for all potential delays well in advance.
I have read and agree to the Travel Competition Policy, including the 24-hour check-in requirement, mandatory away practices, full practice gear requirements, awards attendance, and the weather/traffic policy.
Parent/Guardian Signature
Date

MonthDayYear
Date
EARLY WITHDRAWAL / QUIT AND REMOVAL FEE AGREEMENT
• Athletes who withdraw from the program at any point during the season, including dismissals, will be subject to an early withdrawal fee based on the time of withdrawal.
• This fee schedule applies to both voluntary withdrawals AND dismissals from the program — athletes who are dismissed for any reason (including conduct violations, non-payment, or policy violations) are subject to the same tiered withdrawal fees.
• June – August withdrawal: $300 early withdrawal fee due upon notice of withdrawal.
• August – January withdrawal: $600 early withdrawal fee due upon notice of withdrawal.
• January – April withdrawal: $900 early withdrawal fee due upon notice of withdrawal.
• Withdrawal fees are in addition to any outstanding tuition, competition fees, uniform costs, or other balances owed to 504 Athletics.
• Withdrawal fees must be paid in full before the athlete's records are released or before the athlete may rejoin any 504 Athletics program in a future season.
• 504 Athletics reserves the right to pursue collection of unpaid withdrawal fees.
• Withdrawal must be submitted in writing to 504 Athletics leadership — verbal notice is not accepted.
I understand and agree to the Early Withdrawal / Quit and Removal Fee Agreement, including the tiered fee schedule based on the time of withdrawal.
Parent/Guardian Signature
Date

MonthDayYear
Date
COMPETITION DAY SCHEDULE & EXPECTATIONS

All athletes and families are expected to follow competition day procedures without exception.
ARRIVAL & UNIFORM REQUIREMENTS:
• Athletes must arrive at the competition venue at the required drop-off time provided by 504 Athletics for each event.
• Athletes must arrive in FULL competition uniform, which includes: uniform top, uniform bottom, competition shoes, bow, hair styled and competition-ready, and a full face of competition makeup. No exceptions.
• Athletes must not show any belly/midriff at any time during the competition.
• Athletes must not wear any jewelry of any kind, including but not limited to earrings, belly rings, rings, bracelets, or necklaces. Jewelry of any kind is a safety violation and is strictly prohibited.
SEND-OFF PROCEDURE:
• At the required send-off time, parents and family members will form a Good Luck Arch for athletes to run through before heading to warm-ups.
• During the send-off, parents may hand athletes any last-minute items such as water or extra clothing.
• After send-off, athletes will proceed with coaches and staff only.
• Parents are highly encouraged to watch the competition from the stands at the time of send-off in order to adhere to fire safety rules and venue capacity regulations.
FIRE SAFETY & HALLWAY POLICY:
• All teams and families are subject to additional fines imposed by the venue and/or fire department for gathering in hallways or restricted areas of any competition venue.
• Any fines issued by the venue or fire department as a result of athletes' families congregating in hallways or unauthorized areas WILL be passed on to the athletes and families responsible.
• Please remain in designated spectator areas at all times to avoid fines and ensure the safety of all attendees.
PICK-UP PROCEDURE:
• Athletes will be picked up by their parent or guardian immediately following their team's awards ceremony.
• Pick-up will take place in the same location as the send-off arch.
• Athletes will not be released until after awards for their team have been completed.
• Athletes must be picked up promptly — do not leave before awards, and be ready at the pick-up location immediately after.
• Any family who removes their athlete from a competition before the awards ceremony is completed will be subject to a $100.00 fine, in addition to any disciplinary action taken by 504 Athletics leadership.
I have read and agree to the Competition Day Schedule & Expectations, including the uniform requirements, jewelry policy, hallway/fire safety fines policy, and send-off and pick-up procedures.
Parent/Guardian Signature
Date

MonthDayYear
Date
Parent/Guardian Printed Name

First NameLast Name
Full Contract Acknowledgment
Parent/Guardian Signature
Today's Date

MonthDayYear
Date
TUMBLING POLICY
• All athletes are required to attend a minimum of 1 hour of mandatory tumbling per week. • If an athlete cannot attend their scheduled class, they must purchase and attend a private lesson to make up the session. • Private lessons can be purchased online through the 504 Athletics App and/or Parent Portal. • Missed tumbling not made up via private will be treated as unexcused per the Practice Policy.
I have read and agree to the Tumbling Policy.
Parent/Guardian Signature
Date

MonthDayYear
Date
GYM MOMS
• Throughout the season 504 Athletics will appoint designated Gym Moms to assist in warm-up and competition areas. • All Gym Moms are USASF background certified and authorized to be present with teams in warm-up and competition areas. • Gym Moms are an extension of 504 Athletics staff and must be given the same respect as coaches and program leadership at all times. • Disrespectful behavior toward any Gym Mom is a violation of the Athlete Code of Conduct.
I understand and agree to the Gym Moms policy and will treat all Gym Moms with the same respect as 504 Athletics staff.
Parent/Guardian Signature
Date

MonthDayYear
Date
FUNDRAISING POLICY
• 504 Athletics will participate in optional fundraising opportunities throughout the year to assist families with program costs. • All fundraising funds earned through 504 Athletics fundraising events must be applied directly to the athlete's 504 Athletics account — funds cannot be redirected to personal accounts. • Fundraising funds are designated solely for 504 Athletics program expenses and may not be used for any purpose outside of the cheerleading program. • Any athlete or family found to be applying fundraising funds directly to a personal account, or using fundraising funds for any purpose other than 504 Athletics cheer-related expenses, will be subject to immediate removal from the program. • Immediate removal due to fundraising violations is subject to the Early Withdrawal / Quit Fee Agreement based on the time of removal.
I have read and agree to the Fundraising Policy, including the requirement that all fundraising funds be applied directly to my athlete's 504 Athletics account.
Parent/Guardian Signature
Date

MonthDayYear
Date
SOCIAL MEDIA POLICY
• All athletes and family members are expected to maintain clean and professional social media accounts throughout the season. Any content deemed inappropriate, offensive, or damaging to the reputation of 504 Athletics may result in disciplinary action up to and including dismissal.
• 504 Athletics apparel, uniforms, and branded gear may not be worn in any social media content, posts, or videos outside of official performances, competitions, and 504 Athletics-sanctioned events without prior written approval from 504 Athletics leadership.
• Negative, derogatory, or disparaging posts about 504 Athletics, its staff, coaches, athletes, or families on any social media platform will not be tolerated and may result in immediate dismissal per the Athlete Code of Conduct.
• Athletes and families may not post competition routines, music, or choreography on social media without express written permission from 504 Athletics leadership.
I have read and agree to the Social Media Policy and understand that violations may result in disciplinary action or dismissal from the program.
Parent/Guardian Signature
Date

MonthDayYear
Date
VARSITY STAY TO PLAY POLICY
• All families attending any Varsity-run competition are required to adhere to Varsity's Stay to Play hotel booking policy without exception.
• Stay to Play applies to all Varsity competitions attended by 504 Athletics, including but not limited to Battle at the Big Top, CheerSport, and NCA.
• Families must be prepared to book hotels through the Varsity Stay to Play portal within the allowable booking time frame provided for each event. Failure to book within the required time frame may result in limited hotel availability.
• All hotel reservations for Stay to Play competitions must be made through the designated Varsity Stay to Play booking system unless an exemption has been approved.
• Families who wish to use hotel points or book independently must complete and submit the required Stay to Play exemption documentation through the Varsity portal. Exemptions are not guaranteed and must be submitted within the required time frame.
• 504 Athletics will communicate Stay to Play deadlines and booking details in advance for each applicable competition — families are responsible for booking promptly upon receiving that information.
• Non-compliance with Varsity Stay to Play policies may result in consequences at the competition level imposed by Varsity, which are outside the control of 504 Athletics.
I have read and understand the Varsity Stay to Play Policy and agree to comply with all hotel booking requirements for applicable competitions, including Battle at the Big Top, CheerSport, and NCA.
Parent/Guardian Signature
Date

MonthDayYear
Date

504 Athletics – Parent/Guardian Consent Form

Athlete Information

Parent/Guardian Information

Emergency Contact

Medical Information

Consent & Authorization

Signature Section

Contract Agreements

PRACTICE POLICY & EXPECTATIONS

PRACTICE VIEWING POLICY

Financial & Tuition Agreement

Athlete Code of Conduct

Media Release Agreement

Uniform & Apparel Agreement

Competition Commitment Agreement

TRAVEL COMPETITION POLICY

EARLY WITHDRAWAL / QUIT AND REMOVAL FEE AGREEMENT

COMPETITION DAY SCHEDULE & EXPECTATIONS

Full Contract Acknowledgment

TUMBLING POLICY

GYM MOMS

FUNDRAISING POLICY

SOCIAL MEDIA POLICY

VARSITY STAY TO PLAY POLICY

FULL CONTRACT ACKNOWLEDGEMENT