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The 80-time National Champions are hosting tryouts for our 2014-2015 competitive cheerleading season for anyone ages 3-19. Over 35 of our graduating seniors have received college scholarships! No experience necessary! All cheerleaders who attend evaluations will be placed on a team, we have a spot for every skill level! There is a $25 clinic fee per cheerleader.

Event:

Start Date/Time:

End Date/Time:

Fee per Family:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact*

Questions/Options:


Child's Name
Child's Birthdate
How did you hear about us? Clarksville family, flyer, radio, referral (please include name)

Additional Information:

Assumption of Risk and Liabilities

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In consideration of being allowed to participate in any way in the classes offered by Clarksville Cheer Extreme programs, related events and activities, I (We) acknowledge, appreciate and agree that:

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT FULLY, UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

1. The risk of injury from the activity involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk of serious injury, such chance of serious injury does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such the attention of the nearest coach/trainer/official immediately; and,
4. I, for myself and on behalf of my heirs, assign personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the CLARKSVILLE CHEER EXTREME their officers, Officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advisers, and, if applicable, owners and lessors of premises used to conduct the event ("Release") WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER
ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.

FOR MINOR AGE PARTICIPANTS
This is to certify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above all the Releases, and, for myself, the heirs, assign, and next of kin, release and agree to indemnify the Releases from any and all liabilities incident to any minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM NEGLIGENCE, OF THE RELEASES, to the fullest extent permitted by law.

I've read the above and agree.

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