Cheerleading Registration

Please fill out the form below and then click on Submit.

Player's Name:*
Home Address: street, city, st, zip*
Gender:*	Age:*	Height:*
Grade this season*	Select Season:*
Practice Conflict - select the day your child CANNOT practice: Mon.Tues.Wed.
Skill Level:	Uniform Size: please be exact*
Parent / Guardian and Emergency Contact Information
Father's Full Name:*
Father's Email*		Cell Number:
Mother's Full Name:*
Mother's Email:*		Cell Number
Emergency Contact: If parent cannot be reached*
Emergency Contact Relationship:		Phone Number:*

Known Medical Conditions
Medical Conditions
Volunteer Opportunities
I would like to be:	Your Name	Your Shirt Size:


Release of Liability/Hold Harmless Agreement
The undersigned Parent/Guardian, in consideration of acceptance of this child as a participant in this activity sponsored by Westerville Christian Church (WCC) does hereby: 1. agree to assume any and all risks and liabilities incidental to the child’s participation; 2. agree that all know medical/health conditions have been disclosed to WCC on this form; 3. acknowledge that no medical insurance is maintained by WCC; such insurance being the sole responsibility of each participant family; and 4. agree to indemnify, defend and hold WCC, their Trustees, Staff, Elders, and Coaches harmless from and against any claim, demand, or liability for any injury or property damage.
I AgreeI Do Not Agree


* Required