EmailMe Form - SWYC Youth Cheerleading

Cheerleader Name *

First Last

I am registering my cheerleader for

2019 Parade Squad Registration

2019 Fall Cheer Registration

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Age *

Birthday *

School Attending *

Future High School *

Parent/Guardian Name *

First Last

Primary Phone *

### - ### - ####

Email *

Health Insurance *

Policy # *

Allergies/Conditions

Doctor Name *

Doctor Phone *

Emergency Contact *

Emergency Contact Phone *

My cheerleader would like to cheer for a friend/relative who plays for CCYF. They are:

My cheerleader would like to cheer with a friend/relative/coach on an SWYC cheer team. They are:

*We will try to accommodate requests for friend/relative teams but we can not guarantee.

Parent Initials *

We give a discount for volunteer coaching... Please ask!

Please send me more information regarding volunteer coaching.

SISTER DISCOUNT: $25.00 off of each sibling registration AFTER the first sibling registration.

Please check if this is your 2nd+ sibling application to recieve the Sister Discount

I/We the parent(s)/guardian of the above named participant, due hereby give permission for the above named participant to participate in SWYC Cheerleading. I/We waive, release, absolve, in-demnify and agree to hold harmless the sponsors, participants and instructors from any and all claim(s) arising out of an injury to said participant, rather the result of negligence or not. SWYC Cheerleading is not affiliated with any public school district or private school.

I/We hereby authorize Emergency Medical Attention in the event my/our child is injured during any and all SWYC Cheerleading activities.

I/We authorize the dissemination of my/our child's name and other information relevant to my/our child's participation in the above referenced activity, and authorize the publication of photographs taken of my/our child while participating in said activities. This release covers the dissemination of personal information over the internet, websites, sports programs, and other publications associated with my/our child's participation in said activities.

I/We have read the above statement, and by signing, do hereby agree to all terms and conditions.

Parent/Guardian Digital Signature *

First Last

PAYMENT INFORMATION
The cost for 2019 Parade Squad is $75
The cost for Fall Side Line cheerleading is $225
This fee includes: official uniform use, accessories, the coverage of the cost of facility usage, coaches training and insurance.

Make Checks Payable To: SWYC Cheerleading

Credit Card Payments Available: for a $5.50 processing fee.

Please check here to have an invoice emailed to you. The entire amount must be paid in full upon receipt of an invoice.

*Installment payment plans are available, contact the program director for details. Must have post dated checks on all installment payment plans!

REFUND POLICY:

* All requests must be made to SWYCcheerleading@gmail.com with the word "REFUND" in the subject line.

* On or before JULY 1, 2019 you can receive a full refund LESS $25.00 FILING FEE.

* After July 1, 2019 NO REFUNDS.

MAIL PAYMENT TO:

P.O. Box 87194
Vancouver, WA 98687