Registration
Are you looking to acquire new skills for college? Guy or Girl - we have the clinic for you! Come Join Iowa Central and United All Stars for some advanced stunting! This clinic will have a heavy emphasis on coed stunting; however if you are looking for group stunting - we will have that too.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone:* Click to Enter an International Number Cell #: Click to Enter an International Number Work #: Click to Enter an International Number
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Name of cheerleader
Age of cheerleader
Indicate what you are looking for coed or group stunt.
Indicate whether you are a base, backspot or flyer.
 
Additional Information:
 
Legal Liability Waiver
Legal Liability and Medical Release Form
" I am the legal guardian/parent or am of legal age and I fully understand that I am responsible for payment of expenses incurred relating to the college cheer coed and stunt clinic.
" I certify that my child or myself is physically capable of participating in the college cheer and stunt clinic with United All Stars,L.L.C. and Iowa Central Community College and have no previous injuries that will effect participation.
" I hereby have been forewarned that participation in this clinic has the following non-exhaustive list of particular risks and injuries including but not limited to: sprains, strains, abrasions, dislocations, fractures, concussions, contusions, blisters, head and neck injuries, illness and even possible death.
" Having been forewarned, I assume all risk and full responsibility in connection with United All Stars, L.L.C and Iowa Central Community College and hereby release all instructors, staff, volunteers, practice and performance facilities, and others involved with United All Stars, L.L.C from any injury that may befall my child.
" I agree to hold harmless United All Stars, L.L.C. and Iowa Central Community College for any injury incurred as a result of my child's or myself's participation.
" I am fully aware of the inherent risks of cheerleading, dance and tumbling and am willing to accept these risks to participants of the college cheer and stunt clinic.
" I understand that United All Stars, L.L.C. and Iowa Central strive to provide the maximum in safety precautions and student training.
" I give permission for any medical treatment necessary in the event of illness or injury at the clinic while participating with United All Stars, L.L.C. and Iowa Central.
" I have provided accurate information to the best of my knowledge regarding my child's health and have alerted the staff of United All Stars, L.L.C with any medical concerns.
" I have read, agree to, and fully understand the information and risks and agree to all payments required for my child as a participant of United All Stars, L.L.C.
" I grant my child permission to be photographed, videotaped, or interviewed for the website, publications or press.

I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*