CNY Storm All Stars Team Information

Transcription

1 CNY Storm All Stars Team Information Founded in 1996, CNY Storm was the first All Star program in NYS and this year we will be celebrating our 18 th season! There s a reason we ve been around this long and we want you and your family to see why! Everyone is welcome to join our teams! Tumbling is not required for all of our teams! We offer teams for all ages, ability levels, and family budgets! Take a few minutes to read over the enclosed details, get the facts, and see why your child should be at CNY! We are the longest running and most successful program not only in Central New York and the Capital District, but in all of NYS! Safe learning environment: proper equipment, proper progression of cheerleading and tumbling skills, structured practices, proper supervision. Staff: experienced, knowledgeable, nationally recognized, USASF credentialed, leaders in our industry, judges, choreographers, and several educators are on our staff. Organized: everything goes out in writing, schedules are given months in advance, constant communication and access to information all season long, regularly scheduled parent meetings, monthly financial statements, and more. Fees: tuition and fees due do not change during the season, there are no money surprises during or at the end of the season. You ll know exactly what will be due all season long by reading this packet. Tumbling instruction is included in our monthly tuition! We do more than cheerleading: we offer community service activities, academic rewards, college scouting opportunities, a family atmosphere, and we teach life skills; including the Powerful Words Character Development curriculum. Fundraising: Our Booster Clubs are here to help you earn money to offset your child s expenses. Fundraisers are offered all season long so you have the opportunity to raise as much as you would like. Some of our families are able to fundraise their whole season! United States All Star Foundation (USASF) member gym: we follow the USASF guidelines and professional code of conduct, all of our athletes are USASF members. And there s more: we build self esteem and confidence, routines are age appropriate, we promote good sportsmanship, everyone is treated the same, our program has dedicated cheerleaders, families, and staff, and we care about your kids!

2 Choose your level of time and financial commitment: LOCAL Local teams practice once a week (plus 1 additional practice the week of a performance/competition), compete locally and within a 2-3 hour radius of Albany/Syracuse with limited overnight stays. Their last competition of the season may be further away and may include a one or two night hotel stay. (5-7 competitions) Local teams to be offered: based on participant s age as of 8/31/13*. Tiny (ages 4-5) Mini (ages 8 & under) Youth/Junior (ages 11& under/ages 14&under) Senior (ages 10-18) Local teams can be Level 1-3 REGIONAL Regional teams practice twice a week, compete locally and will do two to three more regional competitions than the local teams, including overnight travel. Regional destinations may include the Northeast, Mid-Atlantic, and Ohio areas. (6-8 competitions) The teams will end their season at the U.S. Finals in Virginia Beach, VA the first weekend of May Regional teams to be offered: based on participant s age as of 8/31/13*. Mini (ages 8 & under) Youth (ages 11 & under) Junior (ages 14 & under) Senior (ages 10-18) Regional teams can be Level 1-4 & 4.2. NATIONAL National level teams practice twice a week, attend most local and regional events, as well as one or two additional National events, including one flight. Destinations in the past have included Dallas, Atlanta, Indianapolis, Myrtle Beach, and Orlando. (8-11 competitions) The teams will end their season at the U.S. Finals in Virginia Beach, VA the first weekend of May National teams to be offered: based on participant s age as of 8/31/13*. Youth (ages 11 & under) Junior (ages 14 & under) WORLD S World s team practices twice a week. These athletes compete at the highest level and will vie for a bid to the 2014 Cheerleading Worlds to be held in Disney World, FL. April 24 th -29 th, The World s Championship is in addition to local, regional, and national competitions. (8-12 competitions) Worlds team to be offered: based on participant s age as of 8/31/13*. Senior (ages 12-18) World s team is a Level 5 team in our Albany gym. Senior (ages 10-18) National teams can be Level 1-4 & 4.2. ALTERNATES Alternates for each team will be selected by the staff (base, backspot, flyer). The alternate will attend 1-3 practices a month to learn the team s skills and routine. They will be asked to fill in when someone is absent from practice and if a team member is injured or ineligible to compete with the team. There is no cost to alternates. Please indicate on your questionnaire if you would like to be considered for an alternate position. CROSSOVERS Cheerleaders can choose to cheer for more than one team within the season. For example, a cheerleader would compete on a Youth and Junior team for the season. Preference for crossovers will be given to experienced cheerleaders. Teams that will utilize crossovers will be determined by the CNY Staff. Please indicate on your questionnaire if you would like to be considered for a crossover position. Cheerleaders will be limited to crossing over to one other cheer team. Cheerleaders are also welcome to crossover to the hip hop teams. Crossovers must come to the additional tryout night for the team/level they are interested in crossing over to. *A copy of the participant s birth certificate is required at team placements.

3 Syracuse Gym 196 Hiawatha Place Syracuse, NY (315) Monday, May 13 th : 6-8pm: Level 1 & 2 teams (all ages, except Tiny team) Tuesday, May 14 th : 6-8pm: Level 3 & 4 teams (all ages) Wednesday, May 15 th : 6-8pm: Last call (all ages, all levels) Tiny team members (ages 4-5) may attend Tiny class June- August, team begins in September. Information meeting for new parents: Monday, May 6 th at 7pm. Albany Gym 45 Railroad Ave. Albany, NY (518) Monday, May 13 th : 6-8pm: Level 5 Worlds team (ages 12-18) Tuesday, May 14 th : 6-8pm: Level 1 & 2 teams (all ages) Wednesday, May 15 th : 6-8pm: Level 3 & 4 teams (all ages) Thursday, May 16 th : 6-8pm: Last call (all ages, all levels) Tiny team members (ages 4-5) do not need to attend team placements. The team will start the week of May 20 th. Information meeting for new parents: Wednesday, May 8 th at 7pm. Team placement requirements: What to bring: $55 Team placement/may tuition $45 Gym registration fee Questionnaire (with photo for new members) *please indicate your team level preference on the questionnaire CNY release form Photocopy of child s birth certificate (new members only) Please arrive early to register and turn in paperwork Signed & notarized rules and financial commitment form (available on our website, click Gym info, then forms What to wear: t-shirt & shorts sneakers hair up, no jewelry Registration forms and tryout fees may be turned in to the Albany or Syracuse gym front desk prior to team placement days. Cheerleaders do not need to master skills at team placements, all ability levels are welcome! Our job is to teach you the skills during the season, this is just an evaluation to see where each child will fit best in our program. The CNY staff will determine which team your child will be placed on based on age, abilities, and the needs of each team. Please refer to the skill levels chart on the next page to have an understanding of team levels and skills preferred for each level. Please also feel free to take advantage of the classes we offer during the month of May to further prepare for team placements. The class schedule and descriptions are available on our website. Please note that team placements will be closed to parents and other spectators. Tentative team placements will be posted on our website: by numbers Friday, May 17 th after 4pm. Cheerleaders will continue to be evaluated the first few weeks of the season and final team placements will be made in July. Please note: in order to fill all teams, we will continue to accept cheerleaders after the initial team placements. Other teams we offer: Auditions for our Albany gym Hip Hop teams will be held May 13 th 16 th. Auditions for our Syracuse gym Hip Hop team TBA. Tryouts for our Open Level 6 teams (ages 17 & older) in the Syracuse gym will be held in late August. Our Special Needs teams will begin in September in Albany and Syracuse. Our half year teams will begin in early November in Albany and Syracuse. Separate information packets for each of the above teams will be added to our website closer to their tryout/audition dates.

4 Understanding All-Star Levels LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4 LEVEL 4.2 LEVEL 5 Tumbling: standing: Tumbling: standing: Tumbling: standing: Tumbling: standing: back back handspring, series handsprings, tucks, handspring tucks, handspring, running: running: round off running: round off running: round off round off series series handsprings handspring tucks handspring layouts handsprings Tumbling: cartwheel, round off, forward roll, front and back walkovers Jumps: beginner jumps with beginner technique/height Stunts: beginner level stunting including two-legged stunting at shoulder level and one-legged stunting at knee level Tosses: no basket tosses are allowed at level 1 Jumps: beginner single jumps & double jumps with beginner technique/height Stunts: beginner level stunting including two-legged stunting at extended level and one-legged stunting at shoulder level Tosses: straight tosses only Jumps: intermediate jumps with good height and jump to back handspring connection Stunts: intermediate stunting including twisting dismounts from two-legged stunts, one-legged stunting at an extended level and some inverted loadins allowed Tosses: basket tosses involving one skill (ex. Toe Touch, Pike, Twist) Jumps: advanced jumps with advanced technique/height and jump to handspring tuck connection Stunts: advanced stunting including twisting dismounts from two-legged stunts, double twisting dismounts from twolegged extended stunts and advanced load-ins Tosses: basket tosses involving two skills (ex. Kick Single Baskets) Jumps: beginner single jumps & double jumps with beginner technique/height Stunts: advanced stunting including twisting dismounts from two-legged stunts, double twisting dismounts from twolegged extended stunts and advanced load-ins Tosses: basket tosses involving two skills (ex. Kick Single Baskets) Tumbling: standing: handspring to full or standing full, running: round off handspring full/doubles Jumps: elite jumps with elite technique/height, and jump to tuck/full connection Stunts: elite stunting including double twisting dismounts from one-legged extended stunts and advanced load-ins Tosses: basket tosses involving three skills (ex. Kick Double Baskets)

5 Time Commitment: Cheerleaders are allowed to participate on other teams, school activities, etc., however all CNY Storm practices, performances, competitions, and other Storm commitments are mandatory and must take priority over the other activities (unless grade related). It is the responsibility of each cheerleader to resolve any conflicts and keep his/her schedule open for their CNY commitments. We have team members relying on each other to be there for all Storm commitments. Cheerleaders must be at the last two practices before a performance or competition, including the Sundays at the end of a holiday/vacation/school breaks including, but not limited to: 12/1/13, 1/5/14, 2/23/14, and 4/13/14 or 4/20/14. Competitions may be during the February & April school breaks. Our attendance policies are strict in order to be fair to everyone on the team. Cheerleaders cannot be a member of another all star program while participating on a CNY Storm team. Pop Warner rules do not allow cheerleaders to participate in all star performances or competitions until their Pop Warner season ends. (Please join us for our half year teams in the fall) Practices: Practices begin the week of May 20 th. Exact days and times will be determined by the results of team placements. The gyms will be closed Monday, 5/27, for Memorial Day and the week of 6/30-7/7, for the 4 th of July holiday. (July tuition is still due by 7/1). Additional Holiday closings will be distributed at Storm Start up Night. Tentative practice days and times will be added to our website calendar by early May. May, June, July and August practices will be during weeknights. September-April practices include Sundays and one weeknight for most regional, national, and Worlds teams. Local teams, except Tiny & Mini, may move to Sunday practices. Local teams will practice 1 day a week. Regional, National, and Worlds teams will practice twice a week. Crossovers must fulfill their commitment to all of their teams practices. Mandatory Stunt & Choreography workshops for each team: (exact dates and times TBD) Tiny & Mini team workshops TBA Youth- some Senior teams will have stunt & pyramid choreography the week of July 22nd-July 26 th, exact days and times TBA. All Youth-Senior level teams will have routine choreography 2 days Tentatively the Syracuse teams will be 8/1-8/6/13 and the Albany teams are tentatively 8/5-8/12/13. Optional Summer Camps includes Team bonding, skills camp, and shared camp with another gym. Details TBA. Mandatory Showoff/Pep Rally, Performances, & Competitions: These begin in late October/early November and continue through the end of April 2014 and some teams may compete the first weekend of May All are mandatory. A tentative competition schedule will be distributed at Storm Start Up Night and the detailed competition information packet will be distributed in early September. Rules and Regulations: It is important to our program s success that everyone is aware of the rules and abides by them. These rules are available on our website, click on Gym Info, then Forms. It is the responsibility of each parent to read the packet in its entirety and discuss them with their child. Each parent/guardian will need to sign and turn in the rules and financial responsibility form by May 20 th in order for their child to participate in practices.

6 Cost You get what you pay for! Fundraising is available to all participants all season long! Team tuition is due by the first of each month June 2013-April Tuition includes cheerleading instruction, tumbling instruction at practice, and one additional class offered at the gym per week. Additional classes will be $10 for hour classes, $5 for half hour classes for Storm cheerleaders/dancers. There is a $25 family tuition discount for the 2 nd /3 rd child. $55/month: Tiny local team, 1.5 practice hours once a week $65/month: Mini local teams, 2 practice hours once a week $75/month: Youth/Junior/Senior local teams, 2 hours once a week (summer), 3 hours once a week (fall) $110/month: Mini/Youth/Junior/Senior regional teams, 2 ½ hours twice a week $115/month: National and World s teams, 2 ½ hours twice a week Competition travel: you make your own arrangements so you can spend as little or as much as you like on hotels, etc. Additional fees due during the season, payments spread out during the season (fees are non-refundable). Types of payments we accept: The adult responsible for payment must provide a credit card or automatic checking withdrawal information for tuition payments. This payment will be automatically charged the first of every month June 2013-April If you choose to pay tuition by check or cash and payment is not received by the 8th of the month the credit card/ach on file will be charged for the tuition, along with the $10 late fee. Fees other than tuition can be paid by cash, check, MC/VISA, Discover, auto pay (credit card or checking account withdrawal). Fees other than tuition charged to a credit card are subject to a 4% service fee. The fee for a returned check, declined credit card or ACH payment is $40. CNY Cheer Company, Inc maintains the right to refuse service at any given time. Please note: Fees are still due if you join late. Fees can be paid prior to due dates. Competition/admin/staff travel fees paid in full by 8/29/13 will receive a 5% discount. There will be a 10% late fee for competitions fees not paid on time. Tiny & Mini local teams: Fee Due by Fee description Amount 6/13/13 Practice wear ($40) Sneakers ($40) $80 6/13/13 ½ of routine choreography & music $38 7/8/13 Balance of routine choreography & music $37 7/22/13 Optional Storm gear items (bags, sweatshirts, etc.) TBD 8/12/13 Uniform (approximate amount) Same uniforms as the season. $125 8/29/13 5% discount off of total competition/admin/staff travel paid by this day -- 9/15/13 First installment of competition fees/staff travel/admin $95 9/15/13 Bow & briefs (approximate amount) $35 10/6/13 Second installment of competition fees/staff travel/admin $95 10/20/13 Optional Storm warm up and Storm gear items TBD 11/10/13 Third installment of competition fees/staff travel/admin $95 1/12/14 Fourth installment of competition fees/staff travel/admin $95 2/2/14 Final installment of competition fees/staff travel/admin $95 Total for season (plus tuition) $790 Youth/Junior/Senior local teams: Fee due by Fee description Amount 6/13/13 Practice wear ($40) Sneakers ($75) $115 6/13/13 ½ of routine choreography & music $175 7/8/13 Balance of routine choreography & music $175 7/22/13 Optional Storm gear items (bags, sweatshirts, etc.) TBD 8/12/13 Uniform (approximate amount) Same uniforms as the season. $295 8/29/13 5% discount off of total competition/admin/staff travel paid by this day -- 9/15/13 First installment of competition fees/staff travel/admin $105 9/15/13 Bow, make up, & briefs (approximate amount) $55 10/6/13 Second installment of competition fees/staff travel/admin $105 10/20/13 Optional Storm warm up and Storm gear items TBD 11/10/13 Third installment of competition fees/staff travel/admin $105 1/12/14 Fourth installment of competition fees/staff travel/admin $105 2/2/14 Final installment of competition fees/staff travel/admin $105 Total for season (plus tuition) $1340

7 Mini/Youth/Junior/Senior Regional teams: Fee due by Fee description Amount 6/13/13 Practice wear ($70) Sneakers ($75) $145 6/13/13 ½ of routine choreography & music $175 7/8/13 Balance of routine choreography & music $175 7/22/13 Optional Storm gear items (bags, sweatshirts, etc.) TBD 8/12/13 Uniform (approximate amount) Same uniforms as the season. $295 8/29/13 5% discount off of total competition/admin/staff travel paid by this day -- 9/15/13 First installment of competition fees/staff travel/admin $170 9/15/13 Bow, make up, & briefs (approximate amount) $55 10/6/13 Second installment of competition fees/staff travel/admin $170 10/20/13 Optional Storm warm up and Storm gear items TBD 11/10/13 Third installment of competition fees/staff travel/admin $170 1/12/14 Fourth installment of competition fees/staff travel/admin $170 2/2/14 Final installment of competition fees/staff travel/admin $170 Total for season (plus tuition) $1695 Youth/Junior/Senior National and World s teams: Fee due by Fee description Amount 6/13/13 Practice wear ($70) sneakers ($75) $145 6/13/13 ½ of routine choreography & music, travel $175 7/8/13 Second ½ of routine choreography & music, travel $175 7/22/13 Optional Storm gear (bags, sweatshirts, etc.) TBD 8/12/13 Uniform (approx. cost) Same uniforms as the season. ($315 for worlds) $295 8/29/13 5% discount off of total competition/admin/staff travel paid by this day -- 9/15/13 First installment of competition fees/staff travel/admin $225 9/15/13 Bow, make up, & briefs (approximate amount) $55 10/6/13 Second installment of competition fees/staff travel/admin $225 10/20/13 Optional Storm warm up and Storm gear items TBD 11/10/13 Third installment of competition fees/staff travel/admin $225 1/12/14 Fourth installment of competition fees/staff travel/admin $225 2/2/14 Final installment of competition fees/staff travel/admin $225 World s commuter package & staff travel (approximate amount) $500 National team total for the season (plus tuition) $1970 World s team total for the season (plus tuition) $2490 Crossover fees: tuition for crossovers is $30/month 6/13/13 ½ of routine choreography & music for second team $175 7/8/13 Second ½ of routine choreography & music for second team $175 9/15/13 First installment of competition crossover fees (estimate) $110 10/6/13 Second installment of competition crossover fees (estimate) $110 11/10/13 Third installment of competition fees/staff travel/admin $110 1/12/14 Fourth installment of competition fees/staff travel/admin $110 2/2/14 Final Installment of competition crossover fees (estimate) $110 Estimated total for the season (plus crossover tuition) $900

8 Storm Start Up Night Parents/Guardians of each cheerleader as well as the cheerleader must attend. There will not be regular practices or classes this night in order for all staff and athletes to attend. Albany Gym: Wednesday, June 12 th at 6:30pm Questions? Syracuse Gym: Thursday, June 13 th at 6:30pm We will be reviewing all of our rules, policies and procedures for the season, the tentative competition schedule, sizing for sneakers, practice wear, uniforms, and more! The Booster Club will also be sharing information on plans for the upcoming season. Please contact one of us: Assistant Program Director: Jennifer Penree, (315) (gym) Program Director: Kathy Penree, (315) (office) Friend us: CNY Storm Follow us: cnyallstars

9 Don t just take our word for it, read what some of our parents have to say about our program: My daughters joined Storm at ages 4 and 7 and are wrapping up their 5th season. Throughout our five years both girls have learned and improved their cheerleading skills and technique. However, the cheerleading is only a piece of what they have gotten from this program. They have been encouraged to volunteer in the community, have been acknowledged for their academic achievements, learned the importance of teamwork and accountability, and have learned the mannerisms and importance of sportsmanship. Gym owner Kathy Penree and her staff build the whole child, not just the cheerleader. ~Chris Smith Our daughter comes from a family that knows sports, but cheerleading we knew nothing and still don't know everything about it. But that is not important. What is important is that she STILL comes off that competition floor with a smile, whether her team wins or lose. She is learning determination, team work, sportsmanship, positive reinforcement, respect towards others and most of all, extended family members. At CNY it is all about becoming a Family. Our owner, Kathy Penree, is all about the children and very well respected in the Cheerleading "World" & our Parents love her. Our coaches, are the best in the area. They take the time to help and TALK to the Cheerleaders. We continue our daughter's journey at CNY because of these reasons and many, many more. We will say that our most important reason is that our daughter IS HAPPY. -Sue & Jody Warman I would like to thank all of the staff of CNY storm for a fantastic program. My son Justin started at the gym 2 years ago with barely a back handspring and now at 11 is working a double full and standing full. The coaches have taught him about dedication, great sportsmanship and the love of the sport!! Thank you, looking forward to many more years of being a part of the CNY family!! -Janet Looman At CNY Storm the owner & coaches are compassionate, and caring. They are all very knowledgeable of the cheer world. The athletes are not only cheerleaders on teams, but they become family to these coaches & staff. Not only do the kids form lifetime friendships but so do the parents. ~Melissa Gage My daughter, Erin, affectionately nicknamed Baby E during her Storm days, was with the program for 7 years. During this time, my baby became a young woman. She was not just coached at CNY Storm, she was nurtured by this amazing surrogate family. Because she doesn t have any siblings, Erin cherished her time at the gym. It was her refuge for managing the stressors of being a teenager; and she always knew she could count on the friendships of fellow athletes, and the neverending support of her coaches. She learned much more than stunting, tumbling and dance at CNY; she mastered her time management skills, fine-tuned her interpersonal communication skills, and this, her last year at Storm, developed some great leadership skills as tri-captain for L5. All this, while also having the opportunity to travel around the country doing what she loved! These years will hold precious memories for our whole family. Like our daughter, my husband and I made wonderful friendships with fellow storm-chasers that will last a lifetime. Thanks to KP, Jenn, and their wonderful staff for always stressing that grades matter as much as their passion for cheerleading (!); and for all you have done for Erin, and all the fine athletes that will follow in her footsteps. -Colleen Bench I feel so blessed and lucky to have been a part of the Storm family since the fall of My daughter Amy is just finishing up her 6th season with Storm and is looking forward to many more! We began with a half-year team hoping to find a place where Amy could continue to cheer once her Pop Warner season was over but we found so much more than that! We found a second family. The coaches, parents and kids at CNY Storm will be part of our lives forever. CNY coaches are skilled professionals who are committed to helping each athlete be the best that he/she can be. Storm consistently puts winning teams on the mat, not because they focus on winning but because they focus on excellence. And while this is competitive cheerleading, the benefits aren't all about competition. My daughter has learned (and continues to learn) so many life lessons at CNY Storm; how to win (and lose) gracefully; how to deal with mistakes and learn from them (both her own and others); how to be a good teammate and a good gymmate; how to take criticism and how to give advice; to be loyal and to be flexible; to be self-confident and humble at the same time. She has met many people from so many different places and is a more well-rounded person because of that. In addition, the gym is a great place to go when she needs a 'break' from the drama that inevitably finds its way into every teen's (or pre-teen's) life. I just can't say enough about how much I love this gym and how happy I am that we found it! -Cassie Castle Jordyn was always memorized by the Storm Cheerleaders at the competitions and used to tell me that when she grows up she was going to be one of them. Well 4 years ago we agreed to let her experience CNY Storm s half year team. Well that was it! Jordyn found her home! Jordyn loves her cheer family and quite honestly so do I! We have laughed, screamed and cried together! As the athletes celebrate their victories as a team and with their coaches, we, the parents are doing the same! It's an amazing feeling watching your child live their passion through the good bad and ugly... And more so... Learn from it, build from it and become a stronger united team! Thank you CNY for providing a place for our children to experience all of these life lessons. She loves you all very much, and as her mother I am truly grateful for all of you! -Tysh Barton

10 CNY Storm All Stars Name: Grade: New team members: Please attach an individual photo here. Thank you. Date of Birth: Age as of 8/31/13 T-shirt size: Shorts size: Address: City: Zip: Home Phone #: ( Participant s Cell #: ( ) ) Athlete Parents responsible for child: Mother s Father s Mother s cell #: ( ) Father s cell #: ( ) Mother s place of employment, with address: Father s place of employment, with address: Hometown newspaper: Have you cheered before No Yes- If so, where How did you hear about our team placements? At which stunt position do you have experience? NONE FLYER BASE BACKSPOT Check your most advanced Stunting skill level: Level 1 (No experience or level 1 stunts, preps) Level 2 (Ex. Preps, Extensions, Straight Cradle dismounts and straight ride baskets tosses) Level 3 (Ex. Extended one-legged stunts, Full twisting two-legged dismounts, single trick basket tosses) Level 4 (Ex. Extended one-legged stunts, Double twisting two-legged dismounts, kick-full basket tosses) Level 5 (Ex. Double twisting one-legged dismounts, kick double basket tosses, full-ups, ball-ups) Check all tumbling skills you can throw on the floor & WITHOUT A SPOT Standing tumbling Standing Series Tumbling Running Tumbling None Multiple Backhandspring None or roundoff Backwalkover BHS tuck Backhandspring Backhandspring Two BHS to tuck Tuck Jump to BHS BHS to layout Layout Tuck Two BHS to layout Full Jump Tuck BHS to full Double full Standing full Two BHS to full I would like to be considered for a: (please indicate your preference starting with 1 for your first choice) Local team Regional team National team Worlds team Crossover team Alternate

11 CNY Storm All Stars For Staff Use Only Registration Fee Amt MOP Date Team Placement Amt MOP Date Birth Certificate Physical USASF Form Rules/Regs/Financial liability Participant s Name: Date of birth: Age (as of 8/31/13): Parent/Guardian s Name: Grade: Address: City: Zip: Home Phone #:( ) Mother s cell phone #:( ) Father s cell phone #:( ) Emergency contact other than parent: Relationship to participant: Cell #:( ) Insurance Carrier: Policy #: Family Physician: Phone #: ( ) Medical History: please provide details for all that apply: Allergies Diabetes Migraines Contact lenses Asthma Epilepsy/fainting Heart trouble Abnormal/irregular menstrual cycle Medical conditions currently being treated Pre-existing injury Medications currently taking I hereby grant permission to licensed hospital and/or health center staff members to administer immediate medical treatment as deemed necessary to my child should he/she be injured during a CNY Cheer Co., Inc/CNY Storm All Stars event (practice, camp, clinic, competition special event, etc.) Further, I understand that I am responsible for payment of expenses related to treatment. I understand there is a risk involved in cheerleading, gymnastics skills, and dance and that the training of these skills includes the risk of minor injuries such as bruises and sprains and more serious injuries such as broken bones, permanent paralysis, or even death from landings or falls on the back, neck, or head. I agree to assume all of the risks inherent in any such activities. I release and forever discharge CNY Cheer Company, Inc./CNY Storm All Stars of and from all claims, judgments, losses, liabilities, damages, costs and expense of any nature ( claims ) arising out of or in anyway connected with my child s participation in such activities. Parent/Guardian signature Date