5678 Cheer / Tumbling Registration

Info about your Athlete:

First NameMiddle NameLast Name

Age:

Birthday:

because we like to party!

Years of Cheerleading:

Years of Tumbling:

Please list ALL Tumbling Skills your Athlete can perform without assistance.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How did you hear about us?

Has your athlete been in another All-Star Program previously? If so, where and for how long?

Parent / Guardian :

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Emergency Contact:

First NameLast Name

Emergency Contact Phone Number:

Please enter a valid phone number.Format: (000) 000-0000.

Hospital of Choice:

Pediatrician:

Insurance Provider:

Group Number:

Insurance Phone No:

Policy Number:

Please list any allergies or medical problems pertinent to your child’s care:

Preferred Class:

I agree to allow 5678 Cheerleading to photograph, videotape and/or audiotape my child for safety, & promotion of classes, clinics and camps.

Policies & Procedures

Policies & Procedures Understanding

Liability & Medical

Name

First NameLast Name

Once you have completed the registration, Coach Robin will review the registration and reach out to your for an eval time that's available and discuss your athlete's placement.

Athletes can be moved up or down in classes based on Coaches discretion, athlete behavior, and skill level.

We take pride in our athletes safely and effectively reaching their goals & full potential as individuals and as teammates.

Our individualized approach to your athletes goals will make the difference between us and any other facility in the area.

We ALL look forward to meeting you & your athlete and helping reach your goals too!

Cheerfully,

Coach Robin 🩷 & the 5678 Coaching Team 🩷

5678 Cheerleading, LLC (931) 246-9596

908 North Main Street Shelbyville, TN 37160