Midwest Cheer Elite All-star Hip Hop Information
|
|
- Georgia Eleanor McKinney
- 7 years ago
- Views:
Transcription
1 Midwest Cheer Elite All-star Hip Hop Information Welcome to Midwest Cheer Elite, Inc. We are delighted that you have chosen to become a part of one of the top All-Star programs in the Midwest! Our mission at Midwest Cheer Elite is to provide life experiences and memories to carry on throughout their lives, through the sport of competitive cheerleading. Our goal every day is to teach our athletes values of commitment, hard work, integrity, leadership, self confidence, positive attitude and a love for the sport. It is our goal to be the very best All-star program in the area, if not the country. Each and every family is important to us and our program. We invite you to come and see what is like to be "One of the Elite!" Please turn in the Evaluation Form (with photo), Member Information Form and Waiver. Athletes will be unable to participate in evaluations without all forms completed by the legal parent/guardian. Q: How Much Does it Cost? A: Approximately $2500-$2900 per season, depending on level. Not included: Uniforms, warm ups, etc. These items will be ordered separately as needed. Travel expenses, Worlds Fee's and banquet are also not included. The cost grid is for single team athletes only Q. Who are the Coaches? A. Coaches are background checked as well as Professional Members of the USASF with certification through their levels. All coaches have also taken the State Mandated Concussion Test! Q. What Competitions Do We Attend? A. Specific competitions will be decided over the summer and will be discussed during your team meeting. Also, all Level 5 teams and Senior Hip Hop will attend NCA/NDA in Dallas. Q. How do you select Teams? A: We select teams to be the most competitive in each level. Remember, you are trying out to be part of Midwest Cheer Elite, not just a specific team or for a specific position. Q. How Often do we practice? A. Twice a week. During the summer you will be either a Mon/Wed team or a Tues/Thursday team and beginning in August you will go to one weekday practice and one Sunday practice per week. Extra practices will be added as we approach competition season. Q: Does everyone make a team? A: All athletes are placed on teams that are suitable for their level Midwest Cheer Elite, Inc maintains the right to refuse services at ANY time. Any Questions may be addressed to: Midwest Cheer Elite, Inc 8730 North Pavilion Drive (513) / info@midwestcheerelite.com PAGE 1
2 Keep this page for reference during the year. Midwest Cheer Elite Payment Schedule Month May June July August September October November December January February March April Fee $215.00/ $250.00(Sr HH) $100.00/ $ (Sr HH) ALL payments will be made to Midwest Cheer Elite, Inc. Your monthly fee includes: * All team practices * Choreography Fee's * Music Fee's * Competition Fee's (7 for Mini Jr HH and 6 for Sr HH) Not included: Uniforms, warm ups, shoes, bows, etc. These items will be ordered separately as needed. Travel expenses, Worlds Fee's and banquet are also not included. Your monthly fee's will be charged to your account on the 15th of the month. Statements will be given out by the 1st of each month. Fee's are due on or before the 15th. On the 16th, any outstanding balance will be charged to your credit card that you provided in your evaluation packet. You can pay in person and Midwest Cheer Elite accepts cash, money orders and all major credit cards. We do not accept checks. If you have any questions about your account, please do not hesitate to call the front office. Accounts not paid in full will be charged a $50 late fee and the athlete will be unable to participate in practices or competitions til the account is brought current. ALL GYM FEE S FROM PRIOR SEASON MUST BE PAID IN FULL BEFORE YOUR CHILD WILL BE ALLOWED TO EVALUATIONS FOR THE UPCOMING SEASON! There will be no refunds made to anyone who is asked to leave the program or that quits a team. If there is a financial problem, please contact the office immediately. Your coach will not be able to advise you on these matters. PAGE 2
3 Turn this page in with your paperwork Evaluation Form Midwest Cheer Elite Name ATTACH PHOTO HERE Age as of August 31, 2015 Birthday (Mm/dd/yy) Grade Are you interested in double teaming meaning you are interested in being on more than one dance team. ** Please keep in mind that athletes crossing from a Sr HH to a Mini-Jr HH team would be responsible for additional competition fee s in the amount of approx.. $630 which are true fee s and crossover fee s. This will be spread out throughout the billing cycle. Also, there is a tuition fee of $52.50 per month for the 2 nd team as well as a choreography fee of $150 Yes, I would be interested in double teaming and understand the extra financial commitment No, I would not be interested in double teaming ===================================================================== If you meet the skill requirements to be part of a Sr Hip Hop would you be interested in doing so? Senior Hip Hop athletes, regardless of age would be asked to attend extra practices, do extra training and attend additional competitions, sometimes at no additional costs. Knowing the commitment, please let us know if you would be willing to accept a Sr HH team position. Yes, I would be interested in having my athlete placed on a Sr Hip Hop, should my child s skills meet the criteria No, I would not be interested in having my athlete placed on a Sr Hip Hop, regardless of my athlete s skill level, at this time Page 3
4 Midwest Cheer Elite, Inc 8730 North Pavilion Drive West Chester, Ohio (513) Turn this page in with your paperwork Guardian Information MEMBER INFORMATION Mother's Name First: Last: Father's Name First: Last: Billing Address Address: City: State Zip Phone Number Mom's Cell # Dad's Cell # Other # Student Information First Last Birthday / / School: Cell Number Insurance Information: Insurance Carrier: Policy # Carrier's Phone Group # Page 4
5 Turn this Page in with your paperwork WAIVER Midwest Cheer Elite, Inc Participant Agreement, Release and Assumption of Risk In consideration of the services of Midwest Cheer Elite, Inc, it's owners, agents, officers, subcontractors, employees and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "MCE"), I hereby agree to release, discharge and hold harmless MCE, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows: 1. I understand and acknowledge that the activities that I or my child engage in while on the premises or under the auspices of MCE pose known and unknown risks which could result in injury, paralysis, death, emotional distress or damage to me, my child, to property, or to third parties. The following describes some, but not all of those risks: Cheerleading and gymnastics, including performances of stunts and use of trampolines, entail certain risks that simply cannot be eliminated without jeopardizing the essential qualities of the activity. Without a certain degree of risk, cheerleading students would not improve their skills and the enjoyment of the sport would be diminished. Cheerleading and gymnastics expose participants to the usual risk of cuts and bruises, and other more serious risks as well. Participants often fall, sprain or break wrists and ankles, and can suffer more serious injuries. Traveling to and from shows, meets and exhibitions raises the possibilities of any manner of transportation accidents. In any event, if you or your child is injured, medical assistance may be required which you must pay for yourself. 2. I expressly agree and promise to accept and assume all of the risks, known and unknown, connected with MCE- related activities, including but not limited to performance of stunts and use of trampolines. My participation and that of my child is purely voluntary. No one has force or coerced me or my child to participate. I elect for myself and my children to participate in such activities in spite of the risks. 3. I hereby voluntarily release, forever discharge and agree to hold harmless and indemnify MCE from any and all liability, claims, demands, actions or rights of actions, which are related to, arise out of or are in any way connected with my child's participation in MCE-related activities. 4. Should MCE be required to incur attorney's fees and cost to enforce this agreement, I agree to indemnify and reimburse them for such fee's and costs. 5. I certify that my child has health, accident and liability insurance to cover bodily injury or property damage that may be caused or suffered while participating in this event or activity, or else I agree to bear the costs of such injury or damage to my child. I further certify that I am willing to assume and bear the costs of all risks that may arise or be created, directly or indirectly, through or by any such condition. Page 5
6 Turn this page in with your paperwork 6. In the event that I file a lawsuit against MCE, I agree to do solely in the State of Ohio and I further agree that the substantive and procedural laws in that state shall apply in any such action without regard to the conflict of laws rules thereof. I agree that if any portion of this agreement is found void or unenforceable, the remaining portions shall remain in full force and effect. 7. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation or the participation of any of my children in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against MCE on the basis of any claim from which I have released MCE by signing this Agreement. I have had sufficient opportunity to read this entire document. I have read it and understand it. I agree to be bound by it's terms. Signature of Participant or parent: Print Name: Date: 2015 PARENTS OR GUARDIAN'S ADDITIONAL INDEMNIFICATION (Must be completed for participants under the age of 18) In consideration of (print minors name ("Minor") being permitted by MCE to participate in it's activities and to use its equipment and facilities, I further agree to indemnify and hold MCE from any and all claims which are brought by, or on behalf of Minor and which are in any way connected with such use or participation by Minor. Parent/Guardian Print Name Date: 2015 Page 6
Professional Preparatory Program Package
Professional Preparatory Program Package GENERAL INFORMATION SANCA s Professional Preparatory Program (P3) is a first step towards a career in circus with a specific focus to prepare graduates for further
More informationWilderness First Aid. Basler Center for Physical Activitiy. Saturday Feb. 25 - Sunday Feb. 26. Non Credit Instruction. Wilderness First Aid
Non Credit Instruction Saturday Feb. 25 - Sunday Feb. 26 Wilderness First Aid Offered at ETSU through Landmark Learning. Saturday Feb. 25 through Sunday Feb. 26 8 a.m 5 p.m. Wilderness First Aid $125 ETSU
More informationARCADIA YOUTH RODEO ASSOCIATION, INC. 124 Heard Street, Arcadia, Florida 34266 863-494-2014 2015-2016 SEASON MEMBERSHIP APPLICATION
2015-2016 SEASON MEMBERSHIP APPLICATION MEMBER INFORMATION: BACK TAG # ISSUED: MEMBER NAME: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CEL #: E-MAIL ADDRESS: (Please send newsletter via: Mail E-Mail ) DATE
More informationPARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
PARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I, the undersigned, on behalf of my minor child: ( Participant ), hereby acknowledge that Participant has
More informationAlabama Elite All Star Cheerleading 2012-2013 Information Packet TEAM SELECTIONS
Alabama Elite All Star Cheerleading 2012-2013 Information Packet Alabama Elite is excited about starting our third season of competitive cheerleading! All Star cheerleading is for kids of all ages and
More informationIMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING
IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING. ASSUMPTION OF RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT This agreement (the Agreement ) must
More informationECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS
ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS Summer Watersports Camp All-Sports Camp Baseball Camp Basketball Camp Golf Camp Sailing Camp Soccer Camp Softball Camp Tennis Camp Volleyball
More informationCHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING
CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING The undersigned, in consideration of being permitted to participate
More informationThank you for your interest in the Illinois Association for College Admission Counseling s 2015 CAMP COLLEGE program!
Greetings! Thank you for your interest in the Illinois Association for College Admission Counseling s 2015 CAMP COLLEGE program! These waiver forms must be completed and submitted in order for your application
More informationAll Students - Please complete items 1-5 All paperwork must have original signatures and be readable. No partial submissions will be accepted.
Independent Study Physical Education (I.S.P.E.) The following items must be on file before your Independent Study application is complete. (1) Complete the online I.S.P.E. contract (keep a copy for your
More informationUNIVERSITY OF HOUSTON
JAMES DICKEY'S UNIVERSITY OF HOUSTON 2014 MEN'S BASKETBALL CAMPS CAMP FEATURES Expert instruction from Houston Basketball staff and student-athletes Outstanding lectures Grouping of all players by ages
More informationWHEREAS, Participants desire to participate in ALL the recreational activities available at the Trampoline Park; and
THIS PARTICIPATION AGREEMENT is made and effective as of the last date executed (hereinafter the "Effective Date") by and between Get Air Savannah (hereinafter "Get Air") and the adult or guardian identified
More informationAquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms
Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms All forms and payment are due no later than June 15, 2015 Note: There is a $25 non-refundable registration fee, and no refunds
More informationRYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME
RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME UNDER 18 YEARS (SIGNED AND INITIALED BY PARTICIPANT AND
More informationName of Coach: Qualifications: (Attach resume) Please list qualifications and experiences relating to coaching this activity:
University of California, Irvine Campus Recreation CLUB SPORTS VOLUNTEER COACH AGREEMENT PLEASE PRINT LEGIBLY Name of Sport Club: Year: Name of Coach: Home Address: Daytime Phone #: Cell Phone #: E-mail
More informationOrlando Junior Academy Afterschool Dance STUDENT REGISTRATION FORM 2014-2015
, Florida 32803 Afterschool Dance STUDENT REGISTRATION FORM 2014-2015 Student #1: _ Student #2: _ Returning Student(s): Please check if account information is the same as last year. Address: Parents Contact
More informationChang Scholarship Student Information
Chang Scholarship Student Information The mission of the Davis Schools Orchestral Music Association (DSOMA) is to support music students and the music program in general. Our music teachers believe that
More informationInitial. Registration Packet. Summer Academy June 3 rd to August 30 th Z M G. www.zmgtennis.com. HP and TTT Registration Form 1 ZMG Tennis, LLC
Registration Packet Summer Academy June 3 rd to August 30 th Z M G www.zmgtennis.com HP and TTT Registration Form 1, LLC Enrolment Process prides its self on offering everything essential in the development
More informationRelease of Liability. Printed Name of Participant:
Release of Liability IN CONSIDERATION of being given the opportunity to participate in any USRowing activity, including scheduled, supervised club activities, and registered regattas, during the policy
More informationCalifornia Polytechnic State University, Pomona Vietnamese Student Association. Family. Honor. Tradition.
California Polytechnic State University, Pomona Vietnamese Student Association Family. Honor. Tradition. ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM Name of Activity or Event: CAL POLY POMONA VSA WINTER
More informationEarn money from you racing, from your pictures, Youtube videos and more! Only by posting on DRR Riders Group on Facebook.
Earn money from you racing, from your pictures, Youtube videos and more! Only by posting on DRR Riders Group on Facebook. Eligibility: All payouts are based on model year Current model year vs non current
More informationHornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823
Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823 Participant Last Name: Participant First Name: Grade: Age: Gender: Male
More information2016 Bowdoin Summer Art Camp Registration
2016 Bowdoin Summer Art Camp Registration Hours and Location Bowdoin Summer Art Camp will run for four weeks from June 27 th through July 22 th. The times and length of each session vary. Please refer
More informationVOLUNTEER ATHLETIC COACHES RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
VOLUNTEER ATHLETIC COACHES RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I, ( Volunteer ), desire to participate as a volunteer athletic coach in the ( Program ) on. I acknowledge
More informationMotorcycle RiderCourse WAIVERS
Motorcycle RiderCourse WAIVERS General Instructions All pages must be completed and signed. If you have any questions, call (231) 591-5819. Mail completed forms to: Motorcycle Rider Courses, Ferris State
More informationINSTRUCTIONS FOR COMPLETING REGISTRATION. 2. Fill out the forms completely with necessary information and signatures:
INSTRUCTIONS FOR COMPLETING REGISTRATION 1. Print out the Waiver of Liability, Medical Release Form and Participant Information Sheet attached to this document 2. Fill out the forms completely with necessary
More information2015 ADF School Medical/Insurance Information & Liability Waivers INSURANCE INFORMATION
These forms must be completed and signed in all appropriate places by the participant, the participant s physician, and if under age 18, by the participant s legal guardian. The medical information we
More informationMath + Leadership Camp at CSUSM Registration Forms
Math + Leadership Camp at CSUSM Registration Forms CONTACT INFORMATION Math for America San Diego Email: sandiego@mathforamerica.org Phone: 858-822-6284 Registration Checklist Complete all sections of
More information2015 Coach E s Flagler College Basketball Camps
2015 Coach E s Flagler College Basketball Camps Necci Brown 2015 Averaged a 31.9 field goal percentage during her career as a Saint July 13-17 Camp Registration Campers cannot be admitted without full
More informationSANTA BARBARA SCHOOL DISTRICTS, SECONDARY EDUCATION INDEPENDENT STUDY PHYSICAL EDUCATION. HOLD HARMLESS AGREEMENT (Agency/Instructor/Coach)
SANTA BARBARA SCHOOL DISTRICTS, SECONDARY EDUCATION INDEPENDENT STUDY PHYSICAL EDUCATION HOLD HARMLESS AGREEMENT (Agency/Instructor/Coach) (Agency/Instructor/Coach) hereby agrees to defend, indemnify and
More informationPersonal/Athletic Training Agreement
Personal/Athletic Training Agreement Standard Fitness Training ½ Hour Session Total Package Cost Price Per Session Expiration Terms Packages 10 Sessions $300 $30.00 Sessions expire 10 weeks 20 Sessions
More informationLegacy Farm Ltd. TRAINING & BOARDING FACILITY 6950 Gaynor Road Goshen, Ohio 45122 Phone: (513) 652-6536 BOARDING AGREEMENT
Legacy Farm Ltd. TRAINING & BOARDING FACILITY 6950 Gaynor Road Goshen, Ohio 45122 Phone: (513) 652-6536 BOARDING AGREEMENT THIS BOARDING AGREEMENT (this Agreement ) is made and entered into as of the day
More informationI UNDERSTAND THAT THESE RISKS MAY RESULT IN INJURY OR EVEN DEATH.
CORNELL COLLEGE S RELEASE, WAIVER AND INDEMNIFICATION AGREEMENT FOR NON-EMPLOYEES ATTENDING FOR CREDIT ACTIVITIES OFFERED BY NON- EIIA MEMBER INSTITUTIONS OR OTHER THIRD PARTIES OR INDEPENDENT STUDY OR
More informationNEVADA SPIRIT TEAM TRYOUTS Cheer/ Pom/Stunt/Mascot
NEVADA SPIRIT TEAM TRYOUTS Cheer/ Pom/Stunt/Mascot General Information Deadlines & Instructions for Application: o All applications must be received by noon, Tuesday, April 24, 2012. Please note: the University
More informationThank you for your interest in Western Carolina University Cheerleading!
Thank you for your interest in Western Carolina University Cheerleading! The Catamount Cheerleaders are prominent fixtures on campus and in the Cullowhee / Sylva community. In addition to cheering for
More informationDate: January 06, 2011 Subject: Technical Letter re: Liability Waivers Handbook Code: RM 2011-01
To: From: Campus Risk Managers Charlene Minnick, Assistant Vice Chancellor, Systemwide Risk Management & Public Safety C: Campus Presidents Gail Brooks, Vice Chancellor, Human Resources Chris Helwick,
More informationINTERNATIONAL LEADERSHIP OF TEXAS
INTERNATIONAL LEADERSHIP OF TEXAS ACKNOWLEDGMENT OF RISK, INDEMNITY, WAIVER AND RELEASE OF LIABILITY AGREEMENT, NOTICE OF FINANCIAL RESPONSIBILITY, AND MEDICAL AUTHORIZATION & INFORMATION FORM IN WITNESS
More informationwithout a signed waiver Santa Fe, NM 87506 Fax: 505 820 Student Name: City: Zip: State: Physician's Name: Parent Name(s): Parent Address: City:
Please mail application to: Las Campanas Compadres, Inc. 15 Buckskin Circle Santa Fe, NM 87506 Fax: 505 820 2709 Las Campanas Compadres, Inc. Student Application Form Please be sure to sign the waiver
More informationINDUSTRIAL CARPET CLEANING SERVICES CONTRACT. THIS AGREEMENT executed on this the day of, 20 by and between. (hereinafter "Employer"), and
INDUSTRIAL CARPET CLEANING SERVICES CONTRACT THIS AGREEMENT executed on this the day of, 20 by and between (hereinafter "Employer"), and (hereinafter "Contractor") NOW, THEREFORE, FOR AND IN CONSIDERATION
More informationDuke GEO Summer Program Participation Agreement
Duke GEO Summer Program Participation Agreement Summer Program Name: Term/Year: Student Full Name: Parent/Guardian Full Name: Student enrollment in Program is not granted until Student and a Parent/Guardian
More informationFOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM
FOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM NOTICE: ALL ATHLETES WILL BE REQUIRED TO HAVE A SIGNED CONSENT FORM BEFORE TAKING THE FIELD. Football Camps of America, LLC. Parental Release Physical Form Waiver
More informationGATEWAY DISCOVERY CAMP
GATEWAY DISCOVERY CAMP SUMMER 2 0 1 6 REGISTRATION FORM Gateway Science Museum will host three sessions of the Gateway Discovery Camp. All sessions run 9am to 3pm and include daily snacks and lunches.
More information~LOTUS GUNWORKS OF SOUTH FLORIDA, LLC~ RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT
~LOTUS GUNWORKS OF SOUTH FLORIDA, LLC~ RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT WHEREAS, in return for being allowed to enter Lotus Gunworks, Lotus Gun Range
More informationAdvanced SPIRIT Association
Advanced SPIRIT Association Registration Packet Ladybug Classic April 5, 2014 Whittemore Center Durham, NH REGISTRATION PACKET CHECKLIST STEP 1: Program Information Please complete all contact information
More informationCONSENT TO PARTICIPATE IN SCHOOL-SPONSORED SPORTS
CONSENT TO PARTICIPATE IN SCHOOL-SPONSORED SPORTS THIS FORM CONTAINS THE CONDITIONS UNDER WHICH YOUR CHILD MAY PARTICIPATE IN THE STRATFORD SCHOOL SPORTS PROGRAM(S). PLEASE ENSURE YOU READ IT CAREFULLY
More information2015 2016 Classes Begin Monday, August 17 th ** = NEW TIMES & CLASSES
2-5 yrs. - PRE - K Monday - 4:15-5:00 T/J - (Pre-K/2-5yrs) Monday - 6:15-7:00 - T/B - (Pre-K/2-5yrs) ** Tuesday - 10:30-11:15 - T/B - (2-5yrs) Wednesday - 10:30 11:15 Ballet/ACRO - (2-5yrs) ** Wednesday-
More informationPEACE DALE SHOOTING PRESERVE RELEASE, WAIVER OF LIABILITY & INDEMNITY AGREEMENT
PEACE DALE SHOOTING PRESERVE RELEASE, WAIVER OF LIABILITY & INDEMNITY AGREEMENT CAUTION: READ THIS AGREEMENT CAREFULLY BEFORE SIGNING In consideration of Peace Dale Shooting Preserve, ("PDSP") furnishing
More informationSouthern California Men's Collegiate Gymnastics Association
SC United Application 2016 Packet www.facebook.com/socalcollegegymnast @SCUgymnastics southerncaliforniaunited scugymnastics SC United Team Application Instructions Thank you for your interest in the SC
More informationKansas Speedway 400 Speedway Blvd Kansas City KS 66111 Ticket Office 913.328.3300 www.kansasspeedwaycorp.com COMING 70E
Kansas Speedway 400 Speedway Blvd Kansas City KS 66111 Ticket Office 913.328.3300 www.kansasspeedwaycorp.com COMING 70E TAKE 435N EXIT 411B TO STATE AVE WEST EXIT 13B COMING 70W TAKE 435N EXIT 411B TO
More informationThe University of Louisiana at Monroe 2015-2016 Cheerleading Tryout Packet
The University of Louisiana at Monroe 2015-2016 Cheerleading Tryout Packet SQUAD DESCRIPTION The ULM Cheer may consist of 4 to 6 co-ed couples and 16 to 20 on All-Girl, numbers may vary depending on available
More informationThe Merritt Kids College Program - A Review
Parent s Name: Address: Email Address: Cell Phone: Emergency Contact Name: Registration Form Home Phone: Number: Child s Name: Grade: Age: School Name: Gender: Male: Female: T-Shirt Size: Small: { } Medium:
More informationTexas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment
Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment Youth s name: Address: Date of birth: Parent/guardian phone: Home Work Pager/Cellular Medical Information
More informationDATE OF BIRTH: STREET ADDRESS: CITY/STATE/ZIP:
Get Noticed Beach Volleyball Waiver WAIVER AND RELEASE, EXPRESS ASSUMPTION OF RISK, INDEMNITY AND HOLD HARMLESS AGREEMENT, AND GRANT OF RIGHTS NAME OF PLAYER: PLAYER AGE DATE OF BIRTH: PLAYER GRADE as
More informationSchool Packet 2016-2017
School Packet 2016-2017 Thank you so much for taking the time to look over the 2016-2017 CheerVille school training information packet. We know that your time is limited with all of the extra planning
More informationCENTRAL MAINE CHRISTIAN ACADEMY 390 Main Street Lewiston, Maine 04240 207.777.0007 www.centralmainechristianacademy.org
CENTRAL MAINE CHRISTIAN ACADEMY 390 Main Street Lewiston, Maine 04240 207.777.0007 www.centralmainechristianacademy.org REGISTRATION FORM (Please Print) STUDENT INFORMATION Student s last name: First:
More information2013 Mid-West Collegiate Championships February 9, 2013
2013 Mid-West Collegiate Championships February 9, 2013 Host: Purdue Judo Club Location: Purdue University Sanction: USA Judo Recreational Sports Center Indiana Judo Inc. 355 N. Martin Jischke Drive West
More informationGeorgia Tech North Ave. NW Atlanta Ga. 30332
Welcome to Fun Weird STEM Saturdays 2014 The functioning objective of Fun Weird Science STEM Saturdays is to: 1. Provide students with hands-on STEM experience; and 2. Engage students in the exciting ways
More informationPRECOLLEGE PERSPECTIVE 2015 RELEASE, WAIVER AND INDEMINIFICATION
PRECOLLEGE PERSPECTIVE 2015 RELEASE, WAIVER AND INDEMINIFICATION Ringling College of Art and Design requires all PreCollege Perspective participants to sign a Release, Waiver and Indemnification Agreement.
More informationCamp Waiver Packet. Student Signature: Date: - - Parent Signature: Date: - - (Parent s signature is required if the student is under the age of 18)
Camp Waiver Packet You should have completed the initial registration and payment process on our website at www.centennialaviationacademy.com prior to completing this packet. If you have not done so, please
More information2016 Summer Camp Registration Form
2016 Summer Camp Registration Form 1 of 6 2016 Summer Camp Registration Form All forms can be found online: http://go.dtcc.edu/swcamps q New Camper q Returning Camper Office Use Only: Identification Number
More informationTaishi Judo Club 5 th Annual Invitational Tournament
Taishi Judo Club 5 th Annual Invitational Tournament Date/Time: Location: Sunday, March 22, 2015. Tournament will start promptly at 10:00AM Northview High School 1016 W. Cypress St. Covina, CA 91722 Sanction:
More information2015-2016 Sport Club Coach Application
2015-2016 Sport Club Coach Application Coach Eligibility Each 2015-2016 Sport Club Coach Application will be reviewed and approved, deferred, or denied, by the Sport Clubs Advisor or representative. An
More informationJune 4, 2015. Dear Parents,
June 4, 2015 Dear Parents, We are excited to offer a special opportunity for your students for the 2015-2016 school year from the Vetri Foundation and the Free Library of Philadelphia. The Free Library
More informationSanta Barbara Unified School District Independent Study Physical Education (ISPE) Criteria and Guidelines
Criteria and Guidelines To qualify for ISPE a student must have a Grade Point Average (GPA) of 2.0 and no conduct violations. In addition, the student must meet the following criteria: The student is an
More informationTARLETON SPORTS MEDICINE. Student-Athlete Medical Information
TARLETON SPORTS MEDICINE Student-Athlete Medical Information TARLETON STATE UNIVERSITY ATHLETICS DEPARTMENT Box T-0080 Stephenville, TX 76402 254-968-9178 254-968-9674 FAX www.tarletonsports.com Dear Parent
More informationBaylor Autism Resource Center Applied Behavior Analysis (ABA) Therapy Program
Baylor Autism Resource Center Applied Behavior Analysis (ABA) Therapy Program Please see the enclosed information and application for more information. The Baylor Autism Resource Center (BARC) Applied
More informationIRELAND STUDY ABROAD APPLICATION May 9 to 22, 2016
Page 1 of 7 Please retain this page for your records do NOT submit with the application IRELAND STUDY ABROAD APPLICATION May 9 to 22, 2016 GENERAL INSTRUCTIONS All students who have registered for the
More informationCONTRACT FOR PRIVATE MUSIC INSTRUCTION
CONTRACT FOR PRIVATE MUSIC INSTRUCTION I. GENERAL CONDITIONS i. Lessons will be offered over the academic year in each of the instruments for which the student is registered. Students will be scheduled
More informationCompass Road to College Summer Tour Application
Compass Road to College Summer Tour Application Student Information Name: Email Address: Sex: F M Birth Date: Primary Language Spoken at Home: English Spanish Other: Current School: School You ll be Attending
More informationKing s Derby Registration Form
Thank you for choosing to enter OBIC s where over $4000 in Cash and prizes will be given away!! It is our heart to be able to offer our services to children and special needs individuals at no cost. Currently
More informationWELCOME TO YMCA Teen Scene Middle School Enrichment Program (This sheet is for parents to keep for informational purposes)
Robert D. Fowler Family YMCA Middle School Enrichment Program Student Registration Form 2015-16 Ivy Prep Academy Program Hours: 7am-7:45am & 4pm-7pm Transportation AM: Group leaves at 7:30am Transportation
More informationPlease list below any medical conditions and/or allergies the DBA Faculty should be
2015-2016 Registration Form Name Of Child(ren): Date of Birth: Address Where Child Resides: Mailing Address (if different from above): Home Phone Number: Please check next to whom the child resides with:
More informationIndianapolis Motor Speedway 4790 West 16 th Street Indianapolis IN 46222 Ticket Office 317.484.6700 www.brickyard400.com
Indianapolis Motor Speedway 4790 West 16 th Street Indianapolis IN 46222 Ticket Office 317.484.6700 www.brickyard400.com From the Airport: Take I-465 north to exit 16A. Turn right at the top of the exit
More informationYALE UNIVERSITY CITIZENS, THINKERS, WRITERS: REFLECTIONS ON CIVIC LIFE APPLICATION FOR SUMMER 2016
NOTE: This application can also be completed online at http://humanities.yale.edu/apply APPLICANT INFORMATION First Name Last Name M.I. Street Address Apt/Unit # City State ZIP Code Student Cell Phone
More informationFURMAN UNIVERSITY SPORTSMEDICINE CENTER
IMPORTANT INSURANCE INFORMATION Dear Parents: Furman University provides an excess coverage policy for our intercollegiate athletes. Incurred medical charges are to be filed with your insurance first.
More informationSOUTHWEST OHIO INLINE HOCKEY PLAYER DOCUMENTATION COVERSHEET
SOUTHWEST OHIO INLINE HOCKEY PLAYER DOCUMENTATION COVERSHEET School / Team: Name: Address: City, State, Zip: Home Phone: Cell Phone: Email: (please circle your responses) Do you attend the above named
More informationAPPENDIX B. Adult Check here if the intern is an adult. Minor Check here if the intern is a minor.
APPENDIX B Adult Check here if the intern is an adult. Minor Check here if the intern is a minor. IMPORTANT: ALL ADULT INTERNS AGREE: [Insert Name] ( Intern ), by my own request, desire to participate
More informationRegistration Instructions 2016. Thanks for joining the Waves Swim Team!
Registration Instructions 2016 Hello, Thanks for joining the Waves Swim Team! Walk Up Registration and Swim Suit fitting March 6 th, 2:00 5:00pm at the Richland Clubhouse. Please fill out: 1. Registration
More informationCornerstone Christian School Athletic Packet 2014-2015
Cornerstone Christian School Athletic Packet 2014-2015 TWELVE VIRTUES FOR THE STUDENT-ATHLETE Athletics serve as an integral piece to the total educational program found at Cornerstone Christian School.
More informationIMPORTANT NOTICE EACH TEAM APPLYING FOR COVERAGE MUST BE A MEMBER OF AMERICAN YOUTH SPORTS ATHLETIC ASSOCIATION
IMPORTANT NOTICE EACH TEAM APPLYING FOR COVERAGE MUST BE A MEMBER OF AMERICAN YOUTH SPORTS ATHLETIC ASSOCIATION TO BE ELIGIBLE FOR THE INSURANCE RATES ON THE FOLLOWING PAGE For fast service fax completed
More informationYOUTH MENTORING PROGRAM. Mentee Application (To Be Completed by the Parent/Guardian)
Personal Information YOUTH MENTORING PROGRAM Mentee Application (To Be Completed by the Parent/Guardian) Youth s Name: Date: Parent/Guardian Name: Relationship to Youth: Mother Father Other, specify: Street
More informationWelcome to Hot Yoga NJ & NY. Teacher Training and Life Optimization Program
Welcome to Hot Yoga NJ & NY Teacher Training and Life Optimization Program Thank you for your interest in training with us. This application and agreement are essential to your registration with our training
More information2015-16 Insurance Information Insurance coverage
2015-16 Insurance Information Insurance coverage At USA Wrestling, our top priorities are safety and security. That's why we make sure you're covered by General Liability, Accidental Medical Expense, and
More informationGUATEMALA SURGERY TRIP Youth Volunteer Information and Release Form
Team Name: Guatemala Surgery Travel Dates GUATEMALA SURGERY TRIP Youth Volunteer Information and Release Form Please complete this entire form, including the release and liability form and return immediately.
More informationFUN IN THE SUN SUMMER DAY CAMP BEHAVIORAL CONTRACT
FUN IN THE SUN SUMMER DAY CAMP BEHAVIORAL CONTRACT This contract is to be signed by both the participant (child) and his or her parent/guardian. This ensures that both the child and the adult understand
More informationSAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS
SAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS I, ( ) the undersigned student wish to participate in a study abroad Program offered by Saint Louis
More informationPET SITTING SERVICE CONTRACT
PET SITTING SERVICE CONTRACT OWNER INFORMATION Name (Please list all Parents) Address City Zip Cell Phone Work Cell E-Mail Address Emergency Contact Name Number How did you hear about us: PET INFORMATION
More informationNEW STUDENT REGISTRATION
NEW STUDENT REGISTRATION High Performance: Academy Prep: Early Childhood: $20.00 registration fee (includes 2 Academy T-shirts) $20.00 registration fee (includes 2 Academy T-shirts) $10.00 registration
More informationHours of Operation Monday Thursday 5 to 8 p.m.
The Jerry Ortiz Memorial Boxing & Youth Fitness Gym is dedicated to enriching the quality of life for children and at-risk youth in the San Gabriel Valley area by promoting physical activity and good sportsmanship
More informationVOLUNTEER APPLICATION
VOLUNTEER APPLICATION The information on this application will help us find the most satisfying and rewarding volunteer service for you. You may include any additional information by attaching it to the
More informationPersonal Medical Conditions. Obligation Regarding Own Medical Insurance. Participation In This Activity Is Voluntary.
Personal Medical Conditions It is your responsibility to check with a medical doctor to see if you (or your ward) have any medical or physical conditions which would preclude or limit your participation
More information2016 Tri Ute Games Ute Indian Tribe Deadline April 6, 2016 Coaches Application
2016 Tri Ute Games Ute Indian Tribe Deadline April 6, 2016 Coaches Application *Must provide a reliable phone number TURN IN COMPLETE APPLICATION TO THE UTE INDIAN TRIBE RECREATION DEPARTMENT 2016 Tri-Ute
More informationTerms and Conditions for Purchase Orders for Recycling Materials
Terms and Conditions for Purchase Orders for Recycling Materials This Agreement is made by and between AEROJET-GENERAL CORPORATION, an Ohio corporation with a place of business at Rancho Cordova, California
More information3004 S. Rancho Dr. Las Vegas, NV. 89102 * PH: 702-220-5614 * www.tevakanui.com
2009/2010 Policy Agreement I have received a copy of the 2009/2010 studio policy and current class schedule. I agree to adhere to all studio policies as contained in this document and explained to me.
More informationTEXAS A&M INTERNATIONAL UNIVERSITY
AGREEMENT FOR WAIVER, INDEMNIFICATION, ASSUMPTION OF RISK AND MEDICAL TREATMENT AUTHORIZATION I,, age, desire to participate voluntarily in all activities of the ( Activity ), which is sponsored or conducted
More informationGUARANTEE (Prime Rate)
GUARANTEE (Prime Rate) TERMS YOU NEED TO KNOW In this document, the terms below have the following particular meanings: (a) Credit Document means any present or future agreement between us and the Customer
More information2016 CHEERFEST Ticket Order Form Saturday, May 14, 2016 Rain Date: Sunday, May 15, 2016* Movietown Arena
Cheer Competition Contact: E-Mail: JANTICO@VARSITY.COM Fax: 732-294-9209 Mail: Six Flags Cheer Competition 17 Raleigh Pass Colts Neck, NJ 07722 For more information on all Six Flags Special Events: Visit:
More information2016 Release and Waiver of Liability PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!
2016 Release and Waiver of Liability PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! This Release and Waiver of Liability (the Release ) is executed on this day of (month),
More information7 th Annual CHICAGO JAZZ PHILHARMONIC
7 th Annual CHICAGO JAZZ PHILHARMONIC Dear Students and Parents: Welcome to the 7 th Annual CJP Jazz Academy. We have an exciting jazz program lined up for the 2 weeks you will be part of our family. Chicago
More informationJ UNE 15 - AUGUST 7 GRADES (going into) HEADSTART - 7th grade
J UNE 15 - AUGUST 7 GRADES (going into) HEADSTART - 7th grade Our day camp offers structured activities from 8:00 a.m. to 5:00 p.m., 5 days a week for an eight-week program, all at one low price. Children
More information