Connect Football Cheerleading 2016
 
Connect Football Cheerleading 2016
First Name  * 
Last Name  * 
Gender  * 
Date of Birthday - MM/DD/YY  * 
Address  * 
City  * 
Zip Code  * 
Best Contact Phone Number  * 
Years of Experience  * 
T-Shirt Size  * 
Warm Up Jacket Size  * 
Warm-Up Pant Size  * 
Does your child have a sibling who will be playing Connect Flag Football?  * 
If yes, Siblings Name:
Would you be willing to help as a parent volunteer?  * 
Parent/Guardian Name  * 
Parent/Guardian Email  * 
Parent/Guardian Phone #  * 
Emergency Contact Name  * 
Emergency Contact Phone #  * 
AUTHORIZATION FOR EMERGENCY & ROUTINE MEDICAL TREATMENT AND RELEASE OF LIABILITY I give my permission to the Connect Sports, its staff, representatives and volunteers, to obtain or provide such emergency or routine medical treatment for my child(ren) as they, in the exercise of their discretion, deem necessary or appropriate while I participate in any activity offered by the Connect Sports. Further, in consideration of the Connect Sports/Eden UB Church making this activity available to me, I, for myself, and anyone claiming under or through me, hereby release and discharge Connect Sports and/or Eden United Brethren Church and its employees, representatives and volunteers from all liability, claims, demands, and actions, regardless of kind or character, connected with, arising out of, or in any way related to my child(ren)'s participation in such activity.
CONSENT TO PHOTOGRAPH/VIDEOTAPE & DISSEMINATE WITHOUT COMPENSATION I hereby consent to my child(ren) being photographed/videotaped while participating in activities offered by Connect Sports. In addition, I consent to the reproduction and use of any such photographs and videotapes by Connect Sports for educational, public relations and promotional purposes and I waive any claim by myself, or anyone claiming under or through me, for compensation of any kind in exchange for such photographs, videotapes and use. I attest that I am eighteen (18) years of age or more and that I am the legal guardian of the child(ren) being registered.
By Signing this box I agree to the consents and releases of liability statements above?  * 
Payment Type  * 
Your Email Address  * 
Total $
 
 
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