CHEERLEADING

CC Panthers Inc. Cheerleading Registration Form

$150

Early Bird Registration May 1 to July 1

$175

General Registration after July 1

$100

Equipment Deposit (refundable once equipment is returned at the end of the season)

Sport Application Information

Player Name (First, Middle, Last)

Date of Birth

Parent/Guardian Name (First, Middle, Last)

Additional Participants

Athlete Name (1), Date of Birth

Athlete Name (2), Date of Birth

Athlete Name (3), Date of Birth

Athlete Name (4), Date of Birth

Address

Phone

Emergency Contact Information

Name of Emergency Contact(s) (First, Middle, Last)

Phone Number

Address

Relation ot Athlete

I hereby declare that I give my full express consent to let my child be given immediate treatment by any qualified medical personnel in circumstances which may need immediate attendance and care.

Medical Information

In case the parent/guardian is out of reach at the time of emergency, with consent of the latter, we will exercise the required diligence needed to have the athlete treated by an E.R Physician. In this regard, we would like to get to know any precautions that we need for the athlete.

Clinic/Hospital

Name of Family Doctor

Any Allergies to Medicine and Antibiotics?

Yes

If Yes, Please List Any Allergies to Medicine to Antibiotics:

Medical Diagnosis:

Medicine Taken

Dosage

Dosage/Frequency Taken

Equipment Return Policy

I am aware that all equipment must be returned within two (2)weeks of the conclusion of the season. If equipment is not returned, the $100 deposit is non-refundable.

Parental/Guardian Consent

I am aware that any physical sport activity may cause accidental injury or harm among the athletes, and I assume any and all possible risk that may cause injury, illness, or death arising to such activity. I agree to waive my right to pursue any claim against the Commission and the Organizing Committee of this event.

Your Signature

Parent/Guardian Name(s)

Select an item ($)

Early Bird Registration - 1 Athlete - $150

Early Bird Registration - 2 Athletes - $300

Early Bird Registration - 3 Athletes - $450

Early Bird Registration - 4 Athletes - $600

CC Panthers Inc. Cheerleading Registration Form​