Krum Youth Cheerleading Registration – 2017
General Information (Please Print Legibly)
Cheerleader Name: / Age (as of right now) / Date of Birth: / Grade (Fall 2017):Physical Address: / City / E-Mail Address:
School Attending (Fall 2017): / Home Phone: / Alternate Phone:
Medical/Emergency Information (This MUST be completed)
Parent/Guardian Name: / Name of Physician: / Insurance Company:Emergency Name/Phone: / Physician Phone: / Group/Policy #:
Hospital to be used: / Drug Allergies: / Specific Medical Concerns:
PERMISSION & RELEASE
I hereby certify that all information about afore said cheerleader has been filled in and is true and correct. I realize this program is a non-profit organization. This is a voluntary program instituted for the benefit of the children in our community and I therefore, hereby agree to hold no party connected with the team activities responsible for injuries to my child during normal pursuit of said activities. If my child is injured during or in conjunction with this sport, I hereby authorize the coach or manager of his/her team to obtain medical attention as he/she may need including surgery for an emergency. I agree to pay all medical and hospital costs for my child’s treatment. In the event you are unable to reach our physician listed above, treatment may be rendered at a clinic or hospital that has been designated by the North Texas Football Association or its’ designee associations. I authorize player photos on the Association’s and/or KYSA’s website or in newspapers as well as any information obtained on this form for the use of data sharing with affiliated associations.
ROLE OF PARTICIPANT & PARENT/GUARDIANS – CODE OF ETHICS
I understand that I am representing my town and youth organization. Participants, parents/guardians include: Parents/Guardians, players, coaches, cheerleaders, spectators and guests. I will obey all bylaws and rules during this season. Any violations of the bylaws and/or rules will automatically remove my child and myself from the Association. Profane language and/or physical violence toward coaches, players, cheerleaders, parents, guests, spectators, Referees will not be tolerated. NO confrontations will be made at any time with the referees. Any coach, player, cheerleader, parent, guest or spectator will be removed for the remainder of the season for broken bylaws.
I have read or been told and fully understand and accept the rules of the North Texas Football Association. I also understand that the NorthTexas Football Association’ Board of Directors can amend and/or change bylaws, at any time. North Texas Football Associations’ Board of Directors and/or Participant leagues reserves the right to limit or remove participation of any person in any participation roles as described above.
Parent/Guardian Signature: / Date Signed:Cheerleader Signature: / Date Signed:
Commissioner Signature: / Date Signed: