JUNCTION CITY CHEERLEADING SPRING KIDS CLINIC 2012

(Register by Wed. June 13, 3:00pm)

WHAT:Have fun with the JC Cheerleaders, play games, learn cheers, jumps, and a dance WHEN: TIME: Friday, June 15, 2012 (last day of schoolearly dismissal) 12:30-6:00pm (Families can arrive at 5:45pm to watch a performance)

FAMILY PERFORMANCE: 5:45pm WHERE: JCHS Cafeteria

TRANSPORATION:Transportation will be provided by First Student Bus leaving from Laurel at 12:30pm and arriving at JCHS at 12:45pm. Coach Raquel will ride on the bus, too. COST:

$35 (includes poms [Poms will be available for the first 60 kids who have registered by

the deadline], snack, dinner, and face tattoo) Wear your I love my Tigers Shirt from past kids clinics or if you dont have one then wear a maroon, white, or gold shirt.

HOW TO REGISTER: Fill out this form and include a $35 cash/check (written out to JCHS Cheer) and drop it off at the Laurel Elementary Office, Oaklea Middle School Office, or JCHS Athletic OfficeBY WEDNESDAY, JUNE 13, 3:00PM.
QUESTIONS: Contact Coach Raquel at 541-760-6606 or email jchscheer@gmail.com NAME:___________________________________________AGE:______GRADE:______ ADDRESS:________________________________________________________________ PARENT/GUARDIAN NAME:________________________________________________ CONTACT NUMBER(S)-Please include home and cellular numbers Home:__________________________________ Cellular:_________________________________ Work:___________________________________ FACE TATTOO: Please only check off if you would NOT LIKE for your child to have a face tattoo (the JC Cheerleaders will help to put them onthey are washable) If you leave this blank then we will have a face tattoo on for your child. _____No, I would not like my child to receive a face tattoo. PARENT/GUARDIAN PERMISSION: Please read and sign on the back of this form. INVITED BY THIS JC CHEERLEADER: ________________________________________________

Release of Liability

I understand by the very nature of the activity, cheerleading carries a risk of potential injury. No matter how careful the child and coach are, I understand that there is a risk of injury. The risk includes minor injuries such as broken bones, dislocations and muscle pulls. The risk also includes catastrophic injuries such as permanent paralysis or even death from landing or falling on the back, head or neck. The undersigned agrees, individually and on behalf of the child, that the child, by and through the undersigned or any other person, will not institute or commence any action at law or equity for any damage of any kind that may be sustained by the child as a result of participation in the program. The undersigned further agrees, individually and on behalf of the child, to release, indemnify and hold harmless Junction City School District its successors, members, directors, officers, coaches, sponsors and volunteers from any claims, demands or actions at law or equity that may subsequently be brought by or on behalf of the child to recover for injuries or damages, including claims for contribution or indemnification made by third parties, arising out of injuries resulting from participation in the program. The above cheerleader has my permission to participate in the Junction City Cheerleading Youth Kids Clinic 2012.

I also give permission for my child to be driven over from Laurel Elementary School to Junction City High School by a School Bus.
_____________________________________________________________ Signature of Parent or Legal Guardian Date