Participant's Full Name (required)
Parents' Names (if under 18)
Date of Birth (dd-mm-yy)
Emergency contact (other than above)
Pre-existing medical conditions
Please indicate which classes you are interested in.
Acro Tumble & Cheer 5-8yrs 3.30-4.30pm Monday WillageeAcro Tumble & Cheer 9-12yrs. 4.30-5.30pm Monday WillageeAcro Tumble (recreation only) Open Age- 4.00-5.00pm Tuesday BictonPom Cheer Dance Open Age – 5.00-6.00pm Tuesday BictonCheer/Acro/Tumble 5-8yrs 3.30-4.30 Thursday PCYC HiltonCheer/Acro/Tumble 9-11yrs Youth L1 - 4.00-5.15pm PCYC HiltonCheer/Acro/Tumble Open Age Level 2 - 4.30-6.00pm PCYC Hiton (Must Tryout)
In consideration for being permitted to participate in any Cheer Dance ‘n Acro activities, I the undersigned, understand, acknowledge and accept that:
* Cheerleading, Acrobatics and some forms of Dance can be a dangerous recreational activity and there is risk of serious injury or even death that may result from activities.
* I knowingly and freely assume all such risks, both known and unknown, and I voluntarily participate at my own risk and assume sole responsibility for any injury, death or property damage I may suffer that arises from my participation in these activities.
* I agree to follow the directions of any CDA staff, teachers, officials or volunteers and that any misconduct or refusal by me to follow any direction of any such staff, teachers, officials or volunteers can result in the cancellation of my participation in the activities and my immediate removal no matter where that may occur. I understand that any such non-compliance may result in injury or death and/or permanent disability as a result of my failure to comply.
* I have had sufficient opportunity to read this assumption of risk agreement, fully understand its terms and sign it freely and voluntarily.
* Cheer Dance n Acro may use, without payment, any written information, name, photograph, videotape or other visual media taken during class or at one of its events. CDA may use this information on our website or in our newsletters to promote CDA and to further our objectives.
This is to verify that I, as a parent / guardian with legal responsibility for this participant, acknowledge, understand and accept ALL OF THE ABOVE and consent and agree to my minor child’s involvement or participation in class enrolled activities.
Alternatively, you can also download our registration form and send it back to us.