Athena Cheer Holiday Program: Event Registration
Event Address: Athena Cheer Academy, Shop 5, 31-79 Paisley Drive, Lawnton
Contact us on (07) 3467 0040 mobile 0432 035 735 or email
Program Dates: Monday 7th Jan to Friday 18th Jan, 2019
Athena's Holiday Program is open to all.

Group Sessions: open to athletes of any age BOOKING REQUIRED
Book either individual sessions or HALF DAY

Monday 7th Jan, 11 - 12.30pm
Tuesday 8th Jan, 6 - 7.30pm
Thursday 10th Jan, 11 - 12.30pm
Friday 11th Jan, 6 - 7.30pm
Monday 14th Jan, 11 - 12.30pm
Thursday 17th Jan, 11 - 12.30pm
Friday 18th Jan, 6 - 7.30pm

Private Tumbling Sessions: Please contact Kerry via email to make a booking.

Full Name of Participant *
Your answer
Date of Birth *
Female/Male *
Parent/Guardian *
Your answer
Mobile Phone Number *
Your answer
Email *
Your answer
Emergency Contact Name (must be different to above) *
Your answer
Mobile Phone Number for Emergency Contact *
Your answer
Please check your chosen session/s
Liability Waiver: I understand that there are risks of physical injury associated with, arising out of and inherent to the activities described in the holiday program. In recognition of this acknowledged risk of injury, I knowingly and voluntarily waive all rights and/or causes of any kind, including any and all claims of negligence arising as a result of such activity from which liability could accrue to Athena Cheer Academy, its officers, agents, employees, instructors, subsidiaries, parent corporations, and all affiliated entities (hereinafter collectively referred to as "Athena Cheer"). I hereby agree to release Athena Cheer and hold Athena Cheer harmless of all liability, and hereby acknowledge that I knowingly and voluntarily assume full responsibility for all risks of physical injury arising out of active participation in cheerleading on behalf of the participant. I am aware that this is a release of liability and an acknowledgement of my voluntary and knowing assumption of risk of injury. I have signed this document voluntarily and of my own free will in exchange for the privilege of participation. I also give Athena Cheer my permission to use my child's picture or video on any form of advertisement for Athena Cheer or an Athena Cheer affiliated event. If I am a minor, my parent and/or legal guardian has signed this document on my behalf releasing Athena Cheer from and all such liability described above and has acknowledged that I am knowingly and voluntarily assuming all risks of injury inherent to this activity. The above named participant has my permission to participate in all Athena Cheer Holiday Program events. I warrant the above information is complete and correct. I hereby authorize Athena Cheer or their agent to act on my behalf to provide emergency medical treatments. I further release Athena Cheer of all liabilities associated with my child's attendance in the Athena Cheer Holiday Program. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service