Cheerleading Registration

Child's name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Parent's name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Emergency contact 1 *

First Name

Last Name

Emergency contact 1's Phone *

(###)

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Emergency contact 2

First Name

Last Name

Emergency contact 2's phone

(###)

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Physician's phone

(###)

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*

I state that I am the parent/legal guardian of the applicant. My child has permission to participate in the Downtown Ministries programs that I designate in this application. I understand that Downtown Ministries is not liable for any incidents that occur during the program. I assume all risks and hazards incidental to such participation, including risks and hazards incidental to the transportation to and from those activities, and hereby waive, release and agree to hold harmless Downtown Ministries, Inc. and its officers, directors, employees, agents, and volunteers, including but not limited to the organizers, officers, supervisors, coaches, volunteers, and persons transporting the applicant whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident or liability insurance. [In the event of an emergency, I authorize permission to seek medical treatment for my child.] I agree that my child may ride in an automobile with Downtown Ministries staff or volunteers in the event that I am unable to transport my child to or from his/her program. I, at all times at the site of any activity, in case of medical emergency, hereby authorize any hospital, doctor, or other licensed medical practitioner, as well as emergency medical treatment personnel, to take what they feel are the correct procedures to aid my child’s health and well being. This permission is extended, as necessary, to Downtown Ministries, Inc. and any other local organization hosting an event or their employees, agents, and volunteers. I also hereby assume the responsibility for payment of any such treatment. If I am present and available at the site and at the time of a medical emergency, I will retain my right to make all necessary decisions concerning medical treatment of my child. I understand that no drugs, drug paraphernalia, weapons, gang signs, gang paraphernalia, or any other illegal activities may be possessed by a participant or otherwise will be tolerated at Downtown Ministries. Any violations of policy may result in immediate dismissal from the program in the sole and absolute discretion of Downtown Ministries. I agree that Downtown Ministries has permission to take and reproduce photographs, video tapings, and interviews of my child for publication, including publication by news sources and other sources for all educational, trade, advertising, and other purposes as determined by Downtown Ministries. I understand that Downtown Ministries is a Christian organization and that my child will participate in daily devotions and Bible teachings. Morals and values will also be used during disciplining and mentoring practices. I understand that cell phones, iPods, mp3 players, portable gaming devices, or any other electronic devices are not permitted at Downtown Ministries programs or events and my child agrees not to possess or have access to any such device while participating in any Downtown Ministries program or event. I understand that Downtown Ministries Program Directors can choose to confiscate these items from my child and return them to me or my child at the end of the program or event.

I have read and agree to the waivers and releases.

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Downtown Ministries staff and volunteers expect respectful behavior, attitudes, and compliance with program rules and discipline. In every program, the following conduct will be enforced: GOOD BEHAVIOR. Each child is expected to maintain respectable behavior towards the staff, program volunteers, other students or program participants, and to themselves while attending the program/event. Chronic misbehavior from any child may result in dismissal from the program/event. Examples of misbehavior and discipline include, but are not limited to, the following: FIGHTING and USE OF PROFANITY. Any fighting or use of profanity during Downtown Ministries programs, events, practices, or games may result in immediate dismissal from participation in that day’s activities. Continued fighting or use of profanity may also result in the child being sent home, dismissal from the program/event, or both. GOOD ATTENDANCE. If a child must miss a day of their program activities, he/she must notify the Program Director or Head Coach. Failure to notify coaches of an absence at practice or a game may result in not participating in a portion of the next game. FOLLOW DIRECTIONS. Downtown Ministries participants MUST adhere to the staff’s and volunteers’ instructions. Failure to do so may result in immediate dismissal from participation in that day’s activities. In the case of continued discipline and/or behavior problems, the participant may be asked to no longer participate in that program for the year. Downtown Ministries reserves the unilateral right to enforce instructions, rules, and discipline through its employees, staff, and volunteers, which includes the right to expel a participant from that program without refund of any money and without a hearing or any appeal.

My child and I have read and understand these rules. We both understand that failure to comply with them can result in my child being dismissed from the program.