Parent Name *

Parent Cell *

Parent E-mail *

Emergency Contact Name and Number *

What is your child's after Cheer Clinic Plan? (walking home, EDP, or car pickup) *

I understand that cheerleading is an active sport and injuries can occur. I agree to hold harmless the Homewood City Board of Education and its employees, and the HHS Varsity Cheerleaders individually. I give permission to the Homewood High School cheerleader sponsors to secure medical attention for my child as deemed necessary. *Type your name below (and include the date) signing that you agree with the statement above. *

Child's - Full Name *

Child's- Elementary School *

Child's - Grade (Please list as either K, 1, 2, 3, 4, 5) *

Child's- Teacher *

Child 's - T-shirt Size Please specify youth or adult. (YXS, YS, YM, YL, YXL, AS, AM, AL) *

Child's - Please list any physical limitations your child may have.

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