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Metro Cheer & Dance Registration and Medical Liability Release Form
Please have your athlete wear black bottoms with tennis shoes. Team Placement T-Shirt will be provided
$45.00 Yearly Registration Fee, $10 Sibling Discount
Registration Fee is Non-Refundable
(Must be filled out in it’s entirety by a parent/guardian)
ATHLETE INFORMATION
Please answer each question completely
Athlete’s First Name *
Your answer
Athlete’s Last Name *
Your answer
Date of Birth *
MM
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DD
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Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Home Phone Number (please include area code) *
Your answer
Athlete's Mobile Phone Number (please include area code) *
Your answer
School *
Your answer
Grade *
Your answer
Athlete's Email Address *
Your answer
Cheer Experience? (not a requirement for team placement) *
Tumbling Experience? (not a requirement for team placement) *
Required
PARENT/GUARDIAN INFORMATION
1st Parent/Guardian Relationship *
Name *
Your answer
Address *
Your answer
Home Phone Number (please include area code) *
Your answer
Work Phone Number (please include area code) *
Your answer
Mobile Phone Number (please include area code) *
Your answer
Email address *
Your answer
2nd Parent/Guardian Relationship *
Name *
Your answer
Address *
Your answer
Home Phone Number (please include area code) *
Your answer
Work Phone Number (please include area code) *
Your answer
Mobile Phone Number (please include area code) *
Your answer
Email address *
Your answer
EMERGENCY CONTACT INFORMATION
Name *
Your answer
Relationship to child *
Your answer
Emergency Phone *
Your answer
Mobile Phone *
Your answer
MEDICAL HISTORY
Any medical history Metro Cheer Staff should be aware of? *
If yes, please describe
Your answer
List Allergies *
Your answer
Does your child require an inhaler? *
If yes, please make sure it is labeled with their name and your athlete has it at all times.
Medications *
Your answer
Health Insurance Company *
Your answer
Policy Number
Your answer
Release of Liability Agreement
I, the undersigned, herby state that I am the parent/legal guardian of the child listed above and that I give permission to him/her to attend and/or participate in any event directed by Metro Training Center. I wish to have my child participate in cheerleading/dance/gymnastics at the facilities provided by Metro Training Center and/or any sponsors/venues of Metro Training Center. I understand that my child’s participation is permitted only on the condition that I enter into this agreement for myself and my child. I recognize that my participation in these activities will expose my child to certain risks, including all of those normally associated with cheerleading/dance/gymnastics. On behalf of myself and my child, I assume the inherent responsibility for any and all injuries and accidents that may occur as the result of my child’s participation in these activities. I hereby release from any liability whatsoever Metro Training Center, its coaches, and staff. I waive any claim that I may later have as a result of any injury to my child which may result from his/her participation in these activities. I hereby give permission to Metro Training Center to take, record and use photographs, videotape and/or audiotape of the above name child in any media for any lawful purpose whatsoever. I waive the right my child or I may have to approve or disapprove the finished product and/or use of such materials and to receive any royalties, profits, or proceeds from such materials or finished product. I have carefully read this release of liability, assumption of risk, and indemnification agreement and fully understand its contents. I am over 18 years of age. I am aware that this is a release of liability and a contract, and I sign it of my own free will.
I have read and agree to the release of liability above. *
Required
Signature *
Your answer
Today's Date *
MM
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DD
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YYYY
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