CBCA Forms

Email Address: _____________________________

Please list what position(s) you are trying out for and/or what position(s) you have experience with (if any):
__________________________________________

Emergency Contact Name: ____________________
Phone Number: _____________________________
Relationship: _______________________________

Any medical problems and/or allergies that the CBCA Staff should be aware of:
__________________________________________

I, the undersigned, do hearby give my consent to particpate in the training and activities provdied by the Cape Breton Cheer All-Stars Organization. I am fully aware of the nature of the activities involved and the possiblity of injuries and/or death which may arise from such activities. In case of illness, injury and/or death that may arise directly or indirectly as a result of participation and/or travel to or from the activity and/or training (ie: cljnic, camp, out of town activities or events), I do hearby grant my permission to the Cape Breton Cheer All-Stars Organization to seek immediate treatment for myself should I be injured. I hearby release the Cape Breton Cheer All-Stars Organization, including it's shareholders, officers, agents, coaches and volunteers from any liability to the above named participant, or any person claiming through him/her, arising from injury to the person or property of the above named participant. In the event of any activities that are televised, I give the Cape Breton Cheer All-Stars Organization the right and permission to film, photograph or videotape myself for any reproductions associated or in any way connected with said televised events, in particular, for use in any promotional purpose or to use on the Cape Breton Cheer All-Stars website.

I, do hereby acknowledge that I intend to participate in one or more athletic endeavors while a member of The Cape Breton Cheer All-Stars, and that I am doing so of my free will. I understand that the coaches/advisors are trained coaches, and are knowledgeable of the rules and regulations of the NSCCA. I further acknowledge that these coaches/advisors will behave prudently in the instruction of cheerleading skills in an effort to avoid injuries and/or accidents from occurring. I realize that participation in athletic endeavors entails the risk of injury to the participants. I accept this risk regardless of the nature of the injury and/or the athletic endeavor in which I will participate. I acknowledge that the term "athletic endeavor" as used herein includes ANY cheerleading activity, drill, stunts, choreography, jumps and gymnastic activities of any kind.

I also waive and absolve the Cape Breton Cheer All-Stars, the coaches, advisors, sponsors, parent volunteers, or other volunteers, the staff and/or volunteers of any of the venues in which we practice and perform, or any more of them or their executors, administrators, heirs, next of kin, successors or assigns, of and from any or all liability and responsibility for injuries, sickness, accidents, and/or natural occurrences during participation by myself in camps, clinics, private coaching, choreography, and any other cheerleading activity. I understand each participant is responsible for his or her own personal health, medical, dental, chiropractic, and accident insurance coverage. MSI coverage and a recent medical are strongly urged. I also understand that all uniforms all the property of the Cape Breton Cheer All-Stars Organization. If I do not return my uniform or if I return it in poor condition I will be responsible to cover the full amount of the uniform cost (.00). I, intending to be legally bound, do hereby, my heirs, executor, and administration, waive, release and forever discharge any and all rights for claims for damage which I may have or may hereafter accrue to myself against The Cape Breton Cheer All-Stars, the coaches, advisors, sponsors, parent volunteers, or other volunteers, the staff and/or volunteers of any of the venues in which we practice or perform, for any damages which may be sustained or sufferer by myself or my family in connection with my association with or participation in, or rising out of travel and/or return from any cheerleading related site or activity affiliated with The Cape Breton Cheer All-Stars.

Dated this ____________ Day of ____________ 20 ____

Name ________________________________________

Signature _____________________________________

Witness ______________________________________

Health Card # _________________________________

Date Of Birth __________________________________

Email ________________________________________

Home Phone and/or Cell Number ___________________________

Emergency Phone Numbers ______________________

Please list 2 emergency phone numbers

PUBLICITY WAIVER AND RELEASE

I, ____________________, will be participating as a member of the Cape Breton Cheer All-Stars. I agree to allow any photos, videos, and/or audio recordings taken of myself at any cheerleading event to be used by the Cape Breton Cheer All-Stars for promotional purposes.

These mediums may include our website at http://www.cbcahurricanes.freewebspace.com as well as newspaper articles and press releases.

I am the witness of the above and have witnessed the person stated above agree to all the terms and agreements stated herein.

	Forms
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TRYOUT WAIVER FORM AND RELEASE Athlete's Name: ____________________________ Address: _________________________________ Home Phone: ___________ Cell Phone: _________ Date of Birth: _________________ Age: _________ School Attending as of Sept. 1st/05: _____________ MSI #: ____________________________________ Email Address: _____________________________ Please list what position(s) you are trying out for and/or what position(s) you have experience with (if any): __________________________________________ Emergency Contact Name: ____________________ Phone Number: _____________________________ Relationship: _______________________________ Any medical problems and/or allergies that the CBCA Staff should be aware of: __________________________________________ I, the undersigned, do hearby give my consent to particpate in the training and activities provdied by the Cape Breton Cheer All-Stars Organization. I am fully aware of the nature of the activities involved and the possiblity of injuries and/or death which may arise from such activities. In case of illness, injury and/or death that may arise directly or indirectly as a result of participation and/or travel to or from the activity and/or training (ie: cljnic, camp, out of town activities or events), I do hearby grant my permission to the Cape Breton Cheer All-Stars Organization to seek immediate treatment for myself should I be injured. I hearby release the Cape Breton Cheer All-Stars Organization, including it's shareholders, officers, agents, coaches and volunteers from any liability to the above named participant, or any person claiming through him/her, arising from injury to the person or property of the above named participant. In the event of any activities that are televised, I give the Cape Breton Cheer All-Stars Organization the right and permission to film, photograph or videotape myself for any reproductions associated or in any way connected with said televised events, in particular, for use in any promotional purpose or to use on the Cape Breton Cheer All-Stars website. Signature: _________________________________ Print Name & Date: __________________________ *Cape Breton Cheer All-Stars Waiver Form and Relase* I, do hereby acknowledge that I intend to participate in one or more athletic endeavors while a member of The Cape Breton Cheer All-Stars, and that I am doing so of my free will. I understand that the coaches/advisors are trained coaches, and are knowledgeable of the rules and regulations of the NSCCA. I further acknowledge that these coaches/advisors will behave prudently in the instruction of cheerleading skills in an effort to avoid injuries and/or accidents from occurring. I realize that participation in athletic endeavors entails the risk of injury to the participants. I accept this risk regardless of the nature of the injury and/or the athletic endeavor in which I will participate. I acknowledge that the term "athletic endeavor" as used herein includes ANY cheerleading activity, drill, stunts, choreography, jumps and gymnastic activities of any kind. I also waive and absolve the Cape Breton Cheer All-Stars, the coaches, advisors, sponsors, parent volunteers, or other volunteers, the staff and/or volunteers of any of the venues in which we practice and perform, or any more of them or their executors, administrators, heirs, next of kin, successors or assigns, of and from any or all liability and responsibility for injuries, sickness, accidents, and/or natural occurrences during participation by myself in camps, clinics, private coaching, choreography, and any other cheerleading activity. I understand each participant is responsible for his or her own personal health, medical, dental, chiropractic, and accident insurance coverage. MSI coverage and a recent medical are strongly urged. I also understand that all uniforms all the property of the Cape Breton Cheer All-Stars Organization. If I do not return my uniform or if I return it in poor condition I will be responsible to cover the full amount of the uniform cost (.00). I, intending to be legally bound, do hereby, my heirs, executor, and administration, waive, release and forever discharge any and all rights for claims for damage which I may have or may hereafter accrue to myself against The Cape Breton Cheer All-Stars, the coaches, advisors, sponsors, parent volunteers, or other volunteers, the staff and/or volunteers of any of the venues in which we practice or perform, for any damages which may be sustained or sufferer by myself or my family in connection with my association with or participation in, or rising out of travel and/or return from any cheerleading related site or activity affiliated with The Cape Breton Cheer All-Stars. Dated this ____________ Day of ____________ 20 ____ Name ________________________________________ Signature _____________________________________ Witness ______________________________________ Health Card # _________________________________ Date Of Birth __________________________________ Email ________________________________________ Home Phone and/or Cell Number ___________________________ Emergency Phone Numbers ______________________ Please list 2 emergency phone numbers PUBLICITY WAIVER AND RELEASE I, ____________________, will be participating as a member of the Cape Breton Cheer All-Stars. I agree to allow any photos, videos, and/or audio recordings taken of myself at any cheerleading event to be used by the Cape Breton Cheer All-Stars for promotional purposes. These mediums may include our website at http://www.cbcahurricanes.freewebspace.com as well as newspaper articles and press releases. Signature of Cheerleader ______________________________ Date ______________________________ I am the witness of the above and have witnessed the person stated above agree to all the terms and agreements stated herein. Signature of Witness _______________________ Date ______________________________