Registration
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Cheer Factory's Online Registration Form
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denotes required fields
Referral Information
How did you hear about us?
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Postcard
Referral
Social Media
Transfer
Website
Referral Name
Family Information
Family Last Name
*
Where do you live?
Home Address
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City
*
State
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AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip
*
Primary Phone
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Additional Info
Emergency Contact Info
*
Health Insurance Carrier
Contact #1
Contact #1 First Name
*
Last Name
*
Type
*
Father
Grandparent
Guardian
Mother
Other
Parent
How Can We Contact You?
Home Phone
Work #
Cell #
*
Portal Access (your email is your login)
Email
*
(Emails are kept confidential)
Confirm Email
*
Portal Account Password
Confirm Portal Account Password
Who is your employer?
Employer
Employer Phone
Employer Notes
Contact #2
Contact #2 First Name
Last Name
Type
Father
Grandparent
Guardian
Mother
Other
Parent
How can we contact you?
Home Phone
Work #
Cell #
Email
(Emails are kept confidential)
Confirm Email
Who is your employer?
Employer
Employer Phone
Employer Notes
Student #1
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Uniform Skirt Small
Uniform Top Small
Warm-Up Jacket Small
Warm-Up Pants Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Primary Doctor
Student #2
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Uniform Skirt Small
Uniform Top Small
Warm-Up Jacket Small
Warm-Up Pants Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Primary Doctor
Student #3
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Uniform Skirt Small
Uniform Top Small
Warm-Up Jacket Small
Warm-Up Pants Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Primary Doctor
Student #4
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Uniform Skirt Small
Uniform Top Small
Warm-Up Jacket Small
Warm-Up Pants Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Primary Doctor
Student #5
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Cell #
Additional Info
Student Email
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Uniform Skirt Small
Uniform Top Small
Warm-Up Jacket Small
Warm-Up Pants Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Primary Doctor
Add Another Student
Required Policies
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I Agree to All of the Above
Enter your Full Name
*
April 18, 2024
Questions or Concerns
Comments
Payment Information
eCheck/Bank Draft
Bank Name
Account Type
Checking
Savings
Your Account Name
(Your name on your bank statement)
Bank Routing Number
(9-digit number)
Account Number