Five Star Elite

Member Information
First Name*
Middle initial *
Last Name
Email
example@example.com
MaleFemale
Address*
City*
State*
Zip*
Birth Date*

MonthDayYear
Which program are you registering for:*
Please note there will be additional fees to participate in both programs (costumes, and competitions) but only one monthly fee.
Parent or Legal Guardian Information
Parent/Legal Guardian*
Relation*
Cell Phone

Area CodePhone Number
Emergency Contact Info
Emergency Number*

Area CodePhone Number
Other Information
YesNo
Health Information
YesNo
Any activity the cheerleader should be restricted from?
Any physical, mental or other condition that would require special attention or medication while at competitions or practices?
List all medications, both prescribed and over the counter
List any allergies (ex: bees,peanuts, dairy)
Any dietary needs that we should know about?
Cheerleader Photo Release
All 5 Star Elite program Members are required to have a head shot on file, please upload it here.
YesNo
Payment Information

Each cheerleader must pay a registration fee of $65 for returners or $75 for new athletes per child. A payment is due at the time of registration. The dates for all other payments are discussed in the handbook.
Do you understand that if you are late to a competition there will be a $50 late fee for each child that rides with you, or your child will be dismissed for non payment. Do you also understand that a missed competition will result in automatic dismissal
AGREEDISAGREE
Practice will be held 2-4 days a week for a maximum of 2.5 hours including water breaks. Your child will also be required to participate in a mentorship program. Research has revealed that group mentoring can provide profound and long-lasting effects for both the youth and their families. Important outcomes including:• increased confidence;• sharpened skills;• expanded understanding of themselves • networking opportunities that expanded beyond the life of the program: solutions to specific problems and challenges; Do you understand that if your child misses 3 days in the period of training (without notice) they will not be allowed to participate in the competitions.
initial to agree
Do you agree As legal guardian, I recognize that potentially severe injuries, including permanent paralysis or death can occur in sports of activities involving height or motion, including but not limited to gymnastics, fitness, tumbling, trampoline, dance, cheerleading, and swimming. In addition, or any activity around water can result in brain damage or drowning. I am also aware that participation in day camps involves transportation to these dangers, I voluntarily consent to the aforementioned person participating in any and all 5 Star Technique and Training programs, camp activities, and ACCEPT ALL RISKS associated with that participation. In consideration for allowing my child to use these facilities, I, on behalf and the behalf of my child and our respective heirs, administrators, executors and successors, hereby COVENANT NOT TO SUE and FOREVER RELEASE 5 Star Elite Training program, its officers, directors, shareholders, employees, or agents of all liability for any and all damages or injuries by my child while under the instruction, supervision, or control of 5 Star Technique and Training program, without limitation, those damages or injuries resulting from acts of negligence of the parts of its officers, directors, shareholders, employees, or agents. In the event of an accident or emergency I would like my above mentioned child to be taken to a hospital for treatment, and I hold 5 Star Elite Training program and its representatives harmless in their execution of this action. Additionally, I hereby agree to individually provide for all future medical expenses which may be incurred by my child as a result of any injury sustained while participating at or for 5 Star Elite Training program. I have read and understand this ASSUMPTION OF RISK and WAIVER OF LIABILITY and MEDICAL AUTHORIZATION and I VOLUNTARILY affix my name in agreement.
Sign to agree
----- FULL SEASON ONLY -----All tuition payments are due on the 13th of each month. •All- members are required to provide payment via the automatic billing system.You will receive an invoice every month on the 24th.
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named cheerleader, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named cheerleader by authorized personnel. The cheerleader will also carry medical insurance. You understand that the above named cheerleader will only be released to the names listed above, an update may be done at registration. You certify that your child has permission to attend camp, showcase, and participate in all activites.

Member Information

Please note there will be additional fees to participate in both programs (costumes, and competitions) but only one monthly fee.

Parent or Legal Guardian Information

Emergency Contact Info

Other Information

Health Information

Cheerleader Photo Release

Payment Information

Credit Card