CV Youth Cheerleading

CV Youth Cheerleading Pre-K through 7th Grade AGE GROUPS Age as of 8/31/2018 Tinys - Age 6 and under Minis - Age 8 and under Pee Wees - Age 10 and under Ponies - Age 12 and under Sideline Cheer Mixed age group INFORMATION Cheerleaders cheer for CVMFA Football with an option to compete/exhibition or only participate in sideline cheer; Note: Tinys are a non-competitive team Registration fees: Tinys & Sideline Cheer $100 Minis, Pee Wees & Ponies $125 New participants must provide a copy of their birth certificate Checks payable: CVYCA All fees are non-refundable $10 sibling discount per additional cheerleader in the family Non-CV Schools: An additional $25 per participant registration fee FALL DUES: For competitive teams For months of Aug, Sept, Oct & Nov Discounted if paid in full by Aug 15 th Tinys & Sideline Cheer None Minis $20 monthly Pee Wees & Ponies $30 monthly UNIFORM FITTINGS: Wed, May 23 Good Hope M. S. Commons registrar@cvcheer.org Cheerleaders wear leotard/bathing suit Parents bring checkbook or cash Tinys & Sideline Minis - Pee Wees - Ponies - 5:30 pm 6:30 pm 7:30 pm 8:30 pm SUMMER MONDAY TEAM TUMBLING: For competitive teams only no tiny or sideline $40 annual insurance fee to USA Stars $5 tumbling sessions begin June 11 Minis 5:45-7 pm Pee Wees 6:45-8 pm Ponies 7:45-9 pm USA Stars, 27 Fairview St, Carlisle Join talented youth rec teams in a season of fun-filled cheerleading. Everyone can be a cheerleader. Everyone makes a team. Cheerleaders will cheer for CVMFA football and also have the option to compete. Coaching is provided by the award winning and nationally ranked Cumberland Valley High School Cheerleaders. 2018 Registration Dates Sporting Hill Fire Department Building 295 South Sporting Hill Road, Mechanicsburg Located across from Hampden Township Administrative Building (not next to Sporting Hill Elementary); turn at light to go back to fire department. Friday, April 13 Saturday, May 5 or 5 pm - 7:30 pm 10 am 1 pm NEW ONLINE REGISTRATION This season we are using TeamSnap to manage online registration. Please use the link below to get started - https://go.teamsnap.com/forms/98720 Questions Contact Amber Earhart, Registrar registrar@cvcheer.org or text Amber at 717-440-3777 Distribution of this material does not constitute endorsement by Cumberland Valley School District. F o r m o r e i n f o r m a t i o n v i s i t w w w. c v c h e e r. o r g 2017-18 CV Youth Cheerleading

2018-19 CUMBERLAND VALLEY YOUTH CHEERLEADING REGISTRATION PARTICIPANT INFORMATION Name: T-Shirt Size: YXS YS YM YL YXL AS AM AL Date of Birth: Age as of 08/31/2018: Grade Next Fall: Street Address: City: State: ZIP Code: Township: School Enrolled in for the Fall of 2018: PARENT/GUARDIAN INFORMATION Mother s Name: Work Phone: Cell Phone: E-mail: Father s Name: Work Phone: Cell Phone: E-mail: ADDITIONAL PARTICIPANT INFORMATION Family Doctor: Allergies (Food/Medicine): Phone: Wears Contacts? Pertinent Medical Conditions: Medications Currently Taking: Hospital Preference: EMERGENCY CONTACT (IF UNABLE TO REACH PARENT/GUARDIAN) Name: Cell Phone: Relationship: Address: City: State: ZIP Code: DISCLAIMER AND ASSUMPTION OF RISK The Cumberland Valley Youth Cheerleading Association is a non-profit, youth recreation program not affiliated with Cumberland Valley School District. CVYCA is supported by registration fees, monthly dues, fundraising and generous sponsorships from businesses in the community. In consideration of participating in this activity, I and/or the participant do hereby assume all risk of injury to the participant and will indemnify and hold harmless, from any and all liability, action, course of actions, claims, and demands of every kind of nature whatsoever that I and/or the participant have or which arise from or in connection with participation in this activity, the Cumberland Valley Youth Cheerleading Association, Inc., or the advisors, coaches, managers, volunteers, successors, and the Cumberland Valley School Board while on the property of the school district, or during an event in which the Cumberland Valley youth cheerleaders may participate. DECLARATION AND CONSENT I declare that to the best of my knowledge and belief that my child is in apparent good health and physical condition to engage in the Cumberland Valley Youth Cheerleading Association team activities. I give my permission for my child named above to participate in the Cumberland Valley Youth Cheerleading Association and understand that registration fees are non-refundable. CVYCA also has my permission to use photographs and videos of my child for any lawful purpose including publicity, illustration, advertising, and web content. To protect the privacy of individuals and children, images will not be identified with full names. Parent/Guardian Signature: Date: CVYCA USE ONLY Circle Cheer Group: 6 & U Tiny Team 8 & U Minis 10 & U - Pee Wees 12 & U - Ponies Sideline Cheer ONLY For FB Games Fees: $ MOP Registration Date: Rcvd: Birth Certificate Waiver/Medical Release

CVYCA Conditions for Participation SUMMER MONDAY TEAM TUMBLING On Monday evenings beginning June 11 through August 20, Mini, Pee Wee and Pony competition teams will work on tumbling skills at the USA Stars Gym, 27 Fairview St. in Carlisle. All participants must pay an annual $40 USA Stars insurance fee at the first tumbling session on Mon, June 11 th and a weekly $5 tumbling fee to the tumbling coaches. We also encourage cheerleaders to attend USA Stars open gyms on Saturdays ($8 per open gym) which are designed to practice and reinforce the skills learned in classes. Cheerleaders need to tumble at least one time per week to maintain skill level. To learn new skills or advance, cheerleaders must tumble a minimum of 2 to 3 times per week. The more a cheerleader tumbles, the better! Parents, please plan carpools in advance. PARENT INITIALS PRACTICES Being a CV youth cheerleader requires significant commitment, but brings with it endless rewards. As the saying goes practice makes perfect so it stands to reason that attending all practices is the first step toward a successful season. In cheerleading, each participant has a unique role in the team s football line-up or competition routine that can only be performed by one specific individual. There is no second string or bench for our teams. In order for a team to practice, cheer at games, or compete, cheerleaders must be willing to make personal sacrifices and attend ALL practices so they are able to work together as a team to achieve their goals. Attendance at all practices is mandatory. CVYCA reserves the right to make changes to team rosters based on poor attendance or financial standing. Team practices for the new season begin on Tues, Aug 7 th with a parent meeting in the Good Hope Auditorium at 6 pm. August practices will be held from 6-7:30 pm on Tuesdays and Thursdays at Good Hope Middle School. The August practice schedule allows for 4-day weekend getaways to the beach and to visit relatives. When school begins, the Pee Wee and Pony teams will practice on Tuesdays and Thursdays at CVHS and ether Saturday or Sunday (depending on FB games and competitions) at USA Stars; Mini teams will practice Mondays and Wednesdays; Sideline Cheer will practice on Mondays; and Tiny teams will practice on Wednesdays. During August or September, evaluations may be held for Pee Wee and Pony cheerleaders to determine placement on a fall team or full season team. Placement will be based on level of interest and individual ability. During registration, parents will have the opportunity to indicate level of interest and commitment on the registration forms. PARENT INITIALS FOOTBALL GAMES The actual football schedule will not be available until the end of May or June. If the schedule is like last year s, the CVMFA football games will be played primarily on Sundays with the possibility of one or two Saturday evening games. Home games will be played @Stoney Ridge, 50 Bernheisel Bridge Rd, Carlisle. Last year, the order on game day was Midgets, Ponies, Pee Wees, and Minis with specific times announced during August. The schedule will vary per cheer team and large cheer teams may be split into two separate cheer groups to take turns cheering at the games or to cover additional games. Please be flexible. 2018 Tentative Schedule for Sunday Football Games (There may be 2 Saturday evening games) 8/26 CVMFA FB Games Week #1 9/30 CVMFA FB Games Week #6 9/2 CVMFA FB Games Week #2 10/7 CVMFA FB Games Week #7 9/9 CVMFA FB Games Week #3 10/14 CVMFA FB Games Week #8 9/16 CVMFA FB Games Week #4 10/21 CVMFA FB Games Week #9 9/23 CVMFA FB Games Week #5 10/28 FB Play-Offs Begin In order to compete as a rec team at cheerleading competitions, our Mini, Pee Wee and Pony cheerleaders must cheer for a recreational sport. In order to fulfill our obligation as a rec cheerleading program, scheduled football games are mandatory. Missed games must be made up. PARENT INITIALS It will be a busy cheerleading season. Commitment to all aspects of the program (registration fees, monthly dues, fundraising, practices, youth cheer camp, community service events, football games, competitions for competitive cheerleaders, uniform care, and transportation to and from all activities) is needed from the parents as well as the cheerleaders. As a cheerleading parent, I am signing this document to indicate that I am willing to abide by the conditions for participation for my child for the 2018-2019 CVYCA season. Cheerleader Circle Level: Tiny Mini Pee Wee Pony Sideline FB Cheer Parent s Signature Date

Which cheer team is right for my cheerleader and our family? The Cumberland Valley Youth Cheerleading Association offers a unique cheerleading program that allows all interested children to be cheerleaders. Our association has a no-cut policy and offers different levels of participation depending on age, level of interest, and experience. All participants are assigned to a team. In an effort to help you make an informed decision regarding the best team fit for your child and your family, please examine the team profiles below. Practices for the Tiny, Mini, Pee Wee, Pony and Sideline Cheer teams will begin on Tues, Aug. 7 th. All teams will practice at Good Hope Middle School on Tuesdays and Thursdays from 6 pm to 7:30 pm. We highly recommend carpooling for all participants. This will make cheerleading more enjoyable for you and your child. In August or September, evaluations may be held for Pee Wee and Pony cheerleaders to determine placement on a fall team or a full season team. Participants will be evaluated on tumbling skills, jumps and a cheer or chant. Cheerleaders will be placed on teams based on individual ability and level of interest. During the cheerleading registration process in April and May, parents will have the opportunity to submit a cheerleading interest form indicating permission for your child to be evaluated for a specific team. The team level you select for your child will indicate that you understand the responsibilities and commitment level required for your child s participation at that level. After you review this material, if you have any questions, please contact Amber Earhart via email at registrar@cvcheer.org. You may also contact Amber by phone at (717) 440-3777 (cell). Team Names -> Sideline Cheerleading for FB Tiny Team Minis, PeeWees, & Ponies Age Levels (As of 8/31/2018) Responsibilities Mixed Age Group Team of: Minis (8 & U), Pee Wees (10 & U), Ponies (12 &U) Cheer at CVMFA home and away football games thru playoffs (Nov) Tinys (6 & Under) Pre-K, Kindergarten Team will cheer for at least 4 home games Exhibition at CV Cheer Classic on Nov 10 and possibly 1 or 2 other competitions Minis (8 & Under) Pee Wees (10 & Under) Ponies (12 & Under) Registration Fees $100 non-refundable fee $100 non-refundable fee $125 non-refundable fee Fall Team: Competes Oct, Nov, and Dec. Full Season Team: Fall & January through Reach the Beach All cheerleaders cheer @CVMFA football games Monthly Membership Dues None None Minis: $20 monthly Aug-Nov PWs & Ponies: $30 monthly Length of Cheer Season August through football playoffs (Nov) Aug through Nov Fall: Aug thru Dec Full-Season: Aug thru Feb Pre-Season Summer Tumbling Not required Not required Minis, Pee Wees & Ponies - $40 USA Stars Insurance Fee Monday evenings ($5.00) @USA Stars beginning June 11 $40 Annual USA Stars gym insurance due on Mon, June 11 Additional Tumbling Instruction Optional if interested, make own arrangements Optional if interested, make own arrangements Private lessons expected make own arrangements Open tumbling - $8 on Sat @USA Stars @9 am Open tumbling - $8 on Saturdays @USA Stars August Practices (Good Hope) Tuesday & Thursday 6-7:30 pm Tuesday & Thursday 6-7:30 pm Tuesday & Thursday 6-7:30 pm CV Cheer Camp @Good Hope Recommended Wed & Thurs, Aug 15 & 16 Highly Recommended Wed & Thurs, Aug 15&16 Expected Wed & Thurs, Aug 15 & 16 Evaluations No evaluations No evaluations Possible evaluations for full season teams held Aug or Sept Practices When School Starts Mondays 6-7 pm Wednesdays 5:30-7 pm Minis: 2 times per week; typically Mon & Wed 6-7:30 pm PWs & Ponies: 3 x per week (includes 1 practice @Stars) Local Gym (USA Stars) Practices None None Football Games CVMFA home & away games thru playoffs (Nov) Team will cheer for at least 4 home games CVMFA games Competitions * Spectator Admission at Competitions No competitions; may perform at Sneak Preview Not Applicable Exhibition at CV Cheer Classic on Nov 10 and 1 or 2 other competitions; Halloween Parade $5.00 - $10.00 Must also pay CV Cheer Classic admission Fundraising Sell at least $125 Yankee Candles or $50 buyout Sell at least $125 Yankee Candles or $50 buyout Minis: No practices @USA Stars PWs & Ponies: Practices on Sat or Sun @USA Stars 12-2 CV Cheer Classic, local & out-of-state competitions (Some comps may require overnight hotel accommodations) $5.00 - $20.00 Must also pay CV Cheer Classic admission Sell at least $125 Yankee Candles or $50 buyout Individual account fundraisers to off-set expenses Uniform Accessories Expense Listed on Anticipated Fees Form Listed on Anticipated Fees Form Listed on Anticipated Fees Form Other Important Notes Season begins Tues, Aug. 7 th @Good Hope This level is an introduction to cheerleading for sideline cheerleading. The emphasis will be cheering for football games and learning basic cheerleading skills (includes stunting for games). * The tentative competition schedule is typically available in mid-october. Season begins Tues, Aug. 7 th @Good Hope This level is an introduction to cheerleading The emphasis will be on learning basic cheerleading skills while having F-U-N. Team tumbling begins Mon, June 11 th @USA Stars. Because these are advanced teams, it may be necessary (in the event of injury/illness to ensure the safety of team members) to call a mandatory emergency practice with less than 24-hours notice to prepare for a competition.

Child s Name Level of Interest for Your Child Grade Next School Year (Aug 2018) I understand that cheerleading evaluations may be held for Pee Wees and Ponies in August or September in order to place cheerleaders on teams based on level of interest and individual ability. Based on the information provided on the registration papers, I am interested in my child participating on the team checked below. Check One Teams Sideline Cheer Fall Only Child s age Tiny Team Fall Only Age 6 and Under Minis, Pee Wees & Ponies Fall Only Teams Pee Wees & Ponies Full Season Teams Level of Commitment Low Low Medium High Explanation Cheer for CVMFA football teams home and away Cheer at several FB games; Participate in Halloween Parade Exhibition at CV Cheer Classic & 1 or 2 other competitions Cheer at FB games; Compete in Fall Competitions Only Cheer at FB games; Fall & Winter Competitions I further understand the responsibilities and commitment required for my child s participation in the CVYCA program and the team she is assigned. Although CVYCA has a no-cut policy and all children are placed on a team, I realize that my child s ability (for the Pee Wee and Pony age groups) is a key factor in team placement. Depending on the number of registrants at the Pee Wee and Pony levels - If an 8-year old consistently executes a back walkover during June tumbling sessions, she may be moved to Pee Wees, if needed. If a 10-year-old consistently executes a back handspring during June tumbling sessions, she may be moved to Ponies, if needed. Also, cheerleaders may be asked to temporarily assist another team or permanently join a different team if openings become available due to illness, injury, resignation or if the number of members on a team is insufficient to be competitive. These situations may happen during any part of the season but typically are handled during the summer months before competitions begin or after competitions conclude for the fall teams. We ask that all cheerleaders and parents be supportive of these changes. Date Parent Signature - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Parent Helpers Parent volunteers contribute to the success of our cheerleading program. Parents are needed to help with advising, fundraising, hair bows, spirit bags, music, coaches gifts, and end of season parties. Please indicate below if you are willing to help in any of these areas. I,, am interested in helping as an advisor. Advisors are team managers who have overall responsibility for the team, communication with parents, advisor meetings, and spotting. Parents, who are selected to be advisors, will be notified prior to the beginning of team tumbling in June. I am interested in helping the team in another way. Area: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Vacations The CVYCA Board, Advisors, and Coaches request that vacations be scheduled during the off-season so as not to interfere with practices, football games, and competition weekends. If at all possible, please plan all summer vacations prior to the start of the new cheer season on Tues, Aug 7 th. We understand this may not be possible for everyone. Please indicate below any vacations you already have planned after August 6 th and the fall. The families of Tiny cheerleaders are asked to keep the dates listed below clear in October and November. Fall team families need to keep the Oct, Nov, & Dec dates clear. Full season families are asked to keep the fall dates listed below clear as well as the weekends listed for the winter season. Thank you very much. Fall Teams: Oct 13, 14, 20, 27 Nov 3, 10, 17 Dec 1, 8, 15 Winter Season: Jan 12-13, 19-20, 26-27 Feb 2-3, 9-10, 16-17, 23-24 (RTB) (Unsure if winter competitions will be Saturdays or Sundays.) PARENT INITIALS

Cumberland Valley Youth Cheerleading Association Waiver and Medical Release I agree that my child,, may engage in physical exercise involving various athletic activities, coordination events, and fitness training which could cause injury. I agree that my child may participate in these activities and will assume all risks of injury that might result. I hereby agree to waive any claims or rights that I might otherwise sue CVYCA, its volunteers, officers, or agents for injuries that might occur as a result of these activities. CVYCA will make no evaluation or recommendation whether a child is physically fit for any exercise activity. It is always advisable to consult a physician prior to undertaking any physical exercise program. If my child has any physical condition that may impair his or her ability to engage in these activities, it is my responsibility as the parent or guardian to obtain a physician s statement describing any limitations for participation in cheerleading. Parent/Guardian Signature Print Name Date Reminder: Please mark your calendar and plan to attend the mandatory parent meeting on Tuesday, August 7, 2018 at 6:00 pm in the Good Hope Middle School Gymnasium. This meeting will be held rain or shine. See you there!

CVYCA Fundraising Participation Dear Cheerleading Parent, For your child to participate in the organization, CVYCA requests your cooperation to either support the organization by assisting with fundraising (selling $125 or more in the Yankee Candle sale) or by participating in the $50 buy-out option. Please complete the section below, sign and return to the organization upon registration. Yes, my child will participate in fundraising and will sell $125 in the Yankee Candle Sale No, my child will not be able to participate in fundraising which requires a $50.00 buyout Child s Name For Buy-Out: Method of Payment Date Received Parent s Name Signature NOTE: To opt out of the fundraising requirement of selling $125 in the Yankee Candle Sale, a $50.00 buyout fee is required to complete the registration process. Thank you! CVYCA 2018-19 Anticipated Fees Cheer Team Fee Description Amount Additional Information Sideline Cheer & Registration 1 $ 100.00 Fee includes insurance, shirt, bow, loan of uniform Tiny Teams Fundraiser Buyout (Optional) 1 $ 50.00 Payable if not participating in fundraiser Registration 1 $ 125.00 Fee includes insurance, shirt, bow, loan of uniform Fundraiser Buyout (Optional) 1 $ 50.00 Payable if not participating in fundraiser Mini Teams USA Stars Annual Membership 2 $ 40.00 Payable to USA Stars on Mon, June 11 @tumbling USA Stars Summer Tumbling Fees 3 $ 5.00 Payable at each tumbling session upon arrival Monthly Membership Dues 4 $ 20.00 Aug, Sept, Oct, & Nov Registration 1 $ 125.00 Fee includes insurance, shirt, bow, loan of uniform Fundraiser Buyout 1 $ 50.00 Payable if not participating in fundraiser Pee Wee / Pony USA Stars Annual Membership 2 $ 40.00 Payable to USA Stars on Mon, June 11 @tumbling Teams USA Stars Summer Tumbling Fees 3 $ 5.00 Payable at each tumbling session upon arrival Monthly Membership Dues 4 $ 30.00 Fall Season Only - Aug, Sept, Oct, Nov Full Season -Aug, Sept, Oct, Nov, Jan, Feb 1 Due April or May Fees due at registration in April or May 2 Due Mon, June 11 $40 payable to USA Stars for annual membership/insurance due Mon, June 11 th @1 st tumbling session 3 Due June, July & Aug $5 payable upon arrival directly to coaching staff at each summer tumbling session 4 Due monthly Aug 15 Monthly membership dues; discounted if paid in full by Aug 15 th ($5 for Minis; $10 for Pee Wees & Ponies) Membership dues cover competition entry fees, USA Stars gym rental fees, music, and choreography fees. Discounts will be offered if entire balance is paid in full at registration or by Aug 15 th : Minis - $5 discount; Pee Wees & Ponies - $10 discount. Dues do not cover the individual uniform accessories listed below payable at uniform fittings on Wed, May 23 rd @Good Hope M.S. Uniform Accessories & Uniform Fittings: Cheerleaders are asked to wear leotards or bathing suits to be sized for uniforms Wed, May 23 rd in Good Hope Middle School Commons, 451 Skyport Rd, Mechanicsburg Bring checkbook or cash 5:30 pm - Tinys & Sideline Cheer Team 6:30 pm - Minis 7:30 pm - Pee Wees 8:30 pm - Ponies Uniform Items Sideline Cheer & Tiny Team Minis, Pee Wees, Ponies Midriff Bodyliner $24 $24 Briefs/Bonnies $24 $24 (extra briefs needed for flyers & tumblers) Select Sneakers (Optional for Sideline Cheer &Tinys) Purchase own plain white sneakers $65 (estimate) Low no-show white socks (details to follow) (details to follow)

Cumberland Valley Youth Cheerleading Association CVYCA 7 Millfording Road Mechanicsburg, PA 17050 Dear Friends of the Community, On behalf of the Cumberland Valley Youth Cheerleading Association, we would like to extend an invitation to you and your company to become a sponsor for our 2018-2019 season. Cumberland Valley Youth Cheerleading Association is a non-profit organization whose mission is to: Acquaint participants with the basic skills, techniques and fundamentals of cheerleading. Provide a safe environment in which children can learn, grow, and have fun. Promote physical fitness and safety first participation. Build self-esteem, self-confidence, and a feeling of accomplishment. Develop personal integrity, discipline, and cooperation. Provide an opportunity for age-appropriate teams to cheer for a recreational sport and to compete. Instill a sense of community service, community pride, and community spirit. We are looking for sponsors who are willing to make a financial contribution to assist our families in covering major expenses such as choreography, music, gym fees, competition fees and administrative costs. If providing a sponsorship for Cumberland Valley Youth Cheerleading Association is an option for you and your company, please take some time to review the sponsorship levels at the bottom of this letter. We are confident you will find a level that will be comfortable for your company as well as beneficial to our organization. We look forward to building a strong partnership with your company that will enable us to fulfill the hopes and dreams of our youth. We welcome any comments or questions regarding the details of your sponsorship and look forward to forming a mutually beneficial partnership. Thank you in advance for your consideration and support of the Cumberland Valley Youth Cheerleading Association. Sincerely, Nicole Seibert, CVYCA President Heather Homan, CVYCA VP Sponsorship Levels GOLD SILVER BRONZE Donation of $1000+ Donation of $500-$999 Donation of $250-$499 Business printed in bold on program shirts Business printed on program shirts Business printed on program shirts Business on landing page of website and on Facebook page Business on CVYCA website under sponsorship tab and on Facebook One-time shout out on Facebook page during fall season & spring season End of season commemorative plaque Recognition at CV Sneak Preview Great way for families to support Monthly shout-out on Facebook page Recognition at CV Cheer Classic CVYCA; cheerleaders love to see Recognition at CV Sneak Preview their family name on back of shirts Recognition at CV Cheer Classic * Checks payable to CVYCA and mailed to: CVYCA, 7 Millfording Road, Mechanicsburg, PA 17050 Program shirts are worn during practices and community events starting in August. The deadline for business promotion on the program shirts is July 13, 2018. Sponsorships will be accepted after the deadline but business names will not appear on the shirts.

VERY IMPORTANT This waiver is for mini, pee wee, and pony competition cheerleaders only who will be tumbling at USA Stars. It does not apply for sideline cheer & tiny cheerleaders. Bring completed USA Stars waiver and $40 cash or check payable to USA STARS on Mon, June 11 Also bring $5 tumbling fee for the tumbling coaches. WAIVER: FACILITY/PRACTICE/TUMBLING FOR NON-USA STARS PARTICIPANTS Expires: PLEASE PRINT PARTICIPANT NAME: DATE: DOB AGE PROGRAM YOU CHEER WITH HOME PHONE: CELL PHONE: ADDRESS: EMAIL #1: EMAIL #2: EMAIL ADDRESS: must be provided so that all efforts can be made to reach you for emergency schedule changes and/or gym closings that affect class sessions and Saturday tumbling. I/we have permission from parents and/or guardians and/or all other responsible parties such as but not limited to parents, guardians, school administrators, athletic directors, gym owners, and other coaches and instructors to practice, jump, stunt, dance, and tumble and otherwise receive instruction at or otherwise use the equipment at the USA Stars facility located at 27 Fairview Street, Carlisle, PA 17015. I/we understand and assume all risks and hazards incidental to such activities, including but not limited to injury (minimal, serious or catastrophic) associated with participation and/or transportation related to practicing, jumping, stunting, dancing, and tumbling and receiving instruction in the USA Stars facility and do hereby waive, release, absolve, indemnify and agree to hold harmless all members of the USA staff, participants, directors, employees, owners, and sponsors; other cheerleaders, instructors and coaches; from any and all claims, demands, costs, expenses, and compensation arising out of or in any way related to an injury (minimal, serious or catastrophic) to any participants, or other damage that may result to said participants, or to members of their families or their households or other individuals invited for whom I/we am/are otherwise responsible, while participating or present at said USA Stars facility, including any physical or other injury (minimal, serious or catastrophic) caused by the negligence of any person or entity described above. Signature of RESPONSIBLE PERSON if PARTICIPANT is UNDER 18 DATE Relationship to participant PRINTED NAME OF RESPONSIBLE PERSON (if participant is under 18) Registration fee $40 paid check # cash receipt # Please Note: No person or persons may practice/tumble and/or receive instruction or use the USA Stars gym and/or equipment without a current waiver and paid registration fee that covers the person or persons for the specified time. All teams and/or other organizations must have a completed waiver and paid fee for every member/participant before using the USA Stars gym and/or equipment.