![3D"Full](3D"waiver_files/image001.gif")
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100 Parker St. Watertown, MA 024=
72 617-393-9714 info@fulloutcheer=
academy.com |
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Club Waiver and Release Form |
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I fully understand that Full Out Cheer Academy staf=
f members are not physicians or medical practitioners of any kind. =
; With the above in mind, I hereby release the Full Out Cheer Academ=
y staff to render first aid to my child or children in the event of any inj=
ury or illness, and if deemed necessary by the Full Out Cheer Academy staff=
to call our doctor and to seek medical help, including transportation by a=
Full Out Cheer Academy staff member or its representatives, whether paid o=
r volunteer, to any health care facility or hospital, or the calling of an =
ambulance for above child should the Full Out Cheer Academy staff deem this=
to be necessary. Parent/Guardian Signature:_________________________=
_______________Date:______________________ |
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STUDENT INFORMATION Cheerleader’s Name________________________________________________=
______________________________________ Sex: =
; M &n=
bsp; F =
; &n=
bsp; Age_________ Address_______________________________________________ Home Phone (_____)__________________________ City: _______________________________________________ State: ___________=
Zip: __________________ Parent/Guardian Name: __________________________________Business/Emergen=
cy Phone (______)_____________________ |
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We, the staff of Full Out Cheer Academy, recognize =
our students and their parents aware of the risks and hazards associated with the sport of cheerle=
ading. Students may suffer in=
juries, possibly minor, serious, or catastrophic in nature. Cheerleading can be dangerous and can lead t=
o injury. Parents should make their children aware of the pos=
sibility of injury and encourage their children to follow all the safety ru=
les and the coaches’ instructions.&n=
bsp; The Full Out Cheer Academy, its coaches and other staff members, will not accept respo=
nsibility for injuries sustained by any student during the course of cheerl=
eading instruction, or open workouts or in a case of any exhibition, compet=
ition, or clinic in which he or she may&nb=
sp; participate while traveling to or from the event. With the above in mind, and being fully awa=
re of the risks and possibility on injury involved, I consent to have my ch=
ild or children participate in the programs offered by Full Out Cheer Acade=
my. I, my executors, or other=
representatives, waive and release all rights and claims for damages that =
I or my child may have against Full Out Cheer Academy and/or its representa=
tives, whether paid or volunteer. I also affirm that I now have and will continue to provide proper hosp=
italization, health, and accident insurance coverage which I consider adequ=
ate for both my child’s protection and my own protection. I also understand that it is the parent=
s’ responsibility to warn the child about the dangers of cheerleading=
and injury. The parents shou=
ld warn the child according to what the parent feels is appropriate. Full Out Cheer Academy will only wa=
rn the child through “Safety Messages” and our teaching style and progression. Parents/Guardian Signature:________________________=
_______________Date:______________________ |