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2019 LNHS Youth Clinic Registration
Please fill out the following information to register your athlete for the 2019 LNHS Youth Clinic. Payment can be dropped off at the front desk of Lake Nona High School in a sealed envelope addressed:
ATTN!: Jessica Paradiso - Youth Cheerleading Clinic

or Payment can be made the day of.

Please have your little athlete come dressed in athletic clothing and bring a water bottle with his or her name on it.
Email address *
Youth Cheerleaders LAST NAME: *
Your answer
Youth Cheerleaders FIRST NAME: *
Your answer
Recruited by: *
Youth Cheerleaders CURRENT AGE: *
Your answer
Youth Size T-Shirt: *
FULL Address: *
Your answer
Parent or Guardian Legal Name: *
Your answer
Parent or Guardian Cell Phone Number: *
Your answer
Parent or Guardian email address : *
Your answer
Youth Cheerleader's Medical Condition or Allergies? *
Your answer
Emergency Contact and Phone Number: *
Your answer
Model Release for Social Media *
Captionless Image
Medical Release *
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Medical Treatment Permission Form: In the event of an emergency occurring while my son/daughter is participating in the cheerleading clinic, I grant permission to the school and its employees to take whatever action necessary. In the event that I can not be reached, I hereby authorize the school and/or its employees to give my son/daughter medical treatment. *
Person To Be Notified Other Than Parent- NAme and Phone Number *
Your answer
Family Doctor: Phone # *
Your answer
If you do not grant permission for your son/daughter to be treated in case of an emergency, what procedure should be followed? *
Your answer
Insurance Company Name: *
Your answer
Insurance Company Policy # : *
Your answer
OCPS Student Contact Card - Please Provide your Student's OCPS ID Number *
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Your answer
I ________________ (parent or guardian of the above registered youth cheerleader) certify that all information on this registration form is correct. (sign name) *
Your answer
A copy of your responses will be emailed to the address you provided.
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