Evaluation and Team Registration Information

Transcription

1 Tryout Date: May 26, 2018 Evaluation and Team Registration Information Time: (3-5 years) 9:00 to 10:00 Time: (6-10 years) 10:00 to 12:00 Time: (11-13 years) 1:00 to 3:00 Time: (14-18 years) 3:00 to 5:00 Tryout Fees: $40 for new athletes $30 for returning athletes $50.00 for any athlete who does not turn in all required paperwork and items at tryouts Required Paperwork: Please complete the following forms Athlete Information Liability/Waiver Form Code of Conduct (Athlete & Parent) Athlete Handbook Acknowledgement Technique Policy Financial Commitment Monthly Payment Method Form Credit Card Authorization Form Team Rep. Form Please attach the following with forms Copy of birth certificate (required for proof of age) Recent photo *photos and birth certificates will be retained for our records and not returned 1

2 ATHLETE INFORMATION Tryout # Athlete s Name Date of Birth Age as of 8/31/18 Address City State Zip Athlete s Home Phone # Athlete s Cell Phone # PARENT/GUARDIAN INFORMATION Mother s Name Contact Home Phone # Work Phone # Cell Phone # Father s Name Contact Home Phone # Work Phone # Cell Phone # BILLING CONTACT INFORMATION If same as Parent/Guardian Info check here Billing Address City State Zip EMERGENCY CONTACT INFORMATION (Other Than Parent) Emergency Contact Relationship to Athlete Home Phone # Work Phone # Cell Phone # Allergies/Medical Conditions Insurance Carrier Policy # Group # Policy Holder I allow my child to be given the following medication(s), if necessary, while at the gym: Tylenol, Advil, Pepto Bismol My child is not to be given any medication while at the gym: I, the undersigned Parent/Guardian/Athlete do hereby give consent for the above athlete to participate in the training and activities held at Lunar Athletics, LLC and accept responsibility for all costs incurred by myself or my athlete. I have completely filled out this form in its entirety and attest that all information given is factual. Signature of Parent/Guardian Date 2

3 PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK In consideration of the services of Lunar Athletics LLC, its owners, agents, officers, employees, and all other persons or entities acting in any capacity on their behalf, I hereby agree to release, discharge, and hold harmless Lunar Athletics LLC, on behalf of myself, my minor children, my parents, my heirs, assigns, personal representative and estate as follows: 1. I understand and acknowledge that the activities that I or [CHILD S NAME] (hereinafter referred to as the Minor ) engage in while on the premises or under the auspices of Lunar Athletics LLC pose known and unknown risks which could result in injury, paralysis, death, emotional distress, or damage to the Minor, to me, to property, or to third parties. The following describes some, but not all, of those risks: Cheerleading and gymnastics, including performances of stunts and use of trampolines, entail certain risks that simply cannot be eliminated without jeopardizing the essential qualities of the activity. Without a certain degree of risk, cheerleading students would not improve their skills and the enjoyment of the sport would be diminished. Cheerleading and gymnastics expose participants to the usual risk of cuts and bruises, and other more serious risks as well. Participants often fall, sprain or break wrists and ankles, and can suffer more serious injuries. When traveling to and from shows, competitions and exhibitions raise the possibilities of any manner of transportation accidents. In any event, if you and/or the Minor are injured, medical assistance may be required which you must pay for yourself. 2. I expressly agree and promise to accept and assume all of the risks, known and unknown, connected with Lunar Athletics LLC-related activities, regardless of the age of the Minor and/or whether or not the Minor is presumed to be able to assume those risks, including but not limited to performance of stunts and use of trampolines. My participation and that of the Minor is purely voluntary. No one has forced or coerced the Minor or me to participate. I elect for the Minor and/or myself to participate in such activities in spite of the risks. 3. I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify Lunar Athletics LLC from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with the Minor s and/ or my participation in Lunar Athletics LLC-related activities. 4. Should Lunar Athletics LLC be required to incur attorney s fees and costs to enforce this agreement, I agree to indemnify and reimburse it for such fees and costs. 5. In the event that I and/or the Minor file a lawsuit against Lunar Athletics LLC, such suit shall be brought in the State of Maryland, and the substantive and procedural laws in that jurisdiction shall apply in any such action without regard to the conflict of laws rules thereof. I agree that if any portion of this agreement is found void or unenforceable, the remaining portions shall remain in full force and effect. This agreement shall be deemed to have been jointly drafted by the parties for all purposes involving its construction and enforcement. 6. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation or the participation of the Minor in this activity, I and/or the Minor may be found by court of law to have waived the right to maintain a lawsuit against Lunar Athletics LLC on the basis of any claim from which I have released Lunar Athletics LLC either personally and/or as the parent, natural guardian and/or legal guardian of the Minor by signing this Agreement. 7. I hereby give Lunar Athletics LLC and its affiliates the unrestricted right and permission to copyright and re-use, publish, and republish photographic portraits and pictures of the Minor and/or myself or pictures in which the Minor and/or myself may be included, in whole or in part, separately or in conjunction with other photographs, in any medium now or hereafter known, and for any purpose whatsoever, including but not limited to illustration, art, promotion, or advertising. 8. In an emergency, I grant permission Lunar Athletics LLC and its personnel, to have authority, at my expense, in the event I cannot be reached, to utilize the most convenient volunteer rescue squad vehicle or ambulance to transport the Minor and/or myself to the hospital and if necessary, I authorize medical treatment. I verify that the Minor and/or myself have passed a medical examination within the last twelve months and are capable of participating in cheerleading, gymnastics, dance and related activities. 9. All monies paid to Lunar Athletics LLC in any capacity are NON-REFUNDABLE, NON-TRANSFERRABLE, and UNASSIGNABLE regardless of reason. I agree that any attempt by Lunar Athletics LLC to collect monies not paid by myself resulting in a collection agency, attorney, or court involvement, I will be responsible for the payment of all collection fees, court costs and attorneys fees incurred by Lunar Athletics LLC and/or myself. I understand that late fees and/or penalties may be applied to all past due payments and/or returned checks. 10. I acknowledge that Lunar Athletics LLC has the right to either suspend or dismiss any participant/customer for any offense, by participant or family member, which we deem detrimental to the entire Lunar Athletics LLC organization. I have had sufficient opportunity to read this entire document. I have been given the opportunity to consult an attorney for any reason regarding this document or in the event I did not understand any provision of this document. By signing below, I have read the document and understand it and I agree to be bound by its terms. Parent/Guardian Signature: Print Name: Date: PARENT S OR GUARDIAN S ADDITIONAL INDEMNIFICATION In consideration of (print minor s name) ( Minor ) being permitted by Lunar Athletics LLC to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold Lunar Athletics LLC from any and all claims which are brought by, or on behalf of Minor and which are in any way connected with such use or participation by Minor. Parent/Guardian Signature: Print Name: Date: 3

4 Lunar Athletics Code of Conduct Athlete s Agreement As an athlete of the Lunar Athletics LLC, I am expected to follow the rules of the program outlined in the handbook & remain in good standing with my fellow teammates and coaches. Failure to abide by this code of conduct may result in disciplinary action or immediate dismissal from the program. Athlete s Signature Date Athlete Name Printed Parent s Agreement I recognize that parents are the most important role models for their children and that athletics help achieve a sense of teamwork, self-worth and sportsmanship. I encourage my child to play by the rules and respect the rights of others. I understand that it is important to enforce the rules of Lunar Athletics LLC, respect the sport of cheerleading & not criticize the judges decisions during or after a competition. I understand that by signing this document, I understand and I agree to comply with all of the rules outlined in the Lunar Athletics Handbook. Failure to abide by this code of conduct may result in disciplinary action or immediate dismissal from the program. Parent s Signature Date Parent s Name Printed 4

5 Handbook Acknowledgment It is the responsibility of the parent and athlete to login to lunarallstars.net under the Forms tab to find the most recent version of our handbook which outlines our policies, procedures and expectations. By signing this document, you certify that you have read, understood and agree with our policies, procedures and expectations. I fully understand this document is a contract between myself and Lunar Athletics, LLC. Parent Signature Date Parent Name Printed Athlete Signature Date Athlete Name Printed 5

6 Technique Policy Tumbling technique is a top priority at Lunar. Our focus is skill perfection prior to progressing to the next level. This approach enables our athletes to achieve their goals in a healthy and positive manner. Proper technique will minimize the chance of an athlete sustaining an injury. Bad tumbling habits are key points that need to be corrected to successfully perform a tumbling skill that is ready to move onto the next level. A tumbling portfolio will be kept on each athlete on what skills they will be allowed to work on in classes, privates, and team practices. An athlete must be signed off in several level appropriate skills in order to move forward in tumbling. Technique is a large part of each tumbling category, i.e., legs together, legs straight, head positioning, no arch in back. Their tumbling portfolio will be monitored on a regular basis. The safety and success of your athlete is our number one priority. Parent Signature Date Parent Name Printed Athlete Signature Date Athlete Name Printed 6

7 Team Representative Form Cheerleader Name Street Address City State County Zip Code School Grade Birth Date Medical Conditions/Allergies Cheerleader Cell Mom Name Cell Mom E Mail Dad Name Cell Dad E Mail T-Shirt Size is our most frequent form of communication. Please keep your team representative updated on any changes. Please include cell numbers that wish to receive team texts. This is important during competition season. 7

8 FINANCIAL COMMITMENT/CREDIT CARD FORM This form must be signed by the parent/guardian that is financially responsible for the payment of the contract. Athlete s Name: Financial Commitment I have read and fully understand my financial commitment to Lunar Athletics, LLC as outlined in this packet. I understand the commitment is for the season of I understand I am giving my Credit/Debit Card information, and that the information will be used if I do not meet the payment deadlines to Lunar Athletics. I also understand that I forfeit any monies paid if I chose to leave a team or if I am asked to leave the program. I understand that no refunds will be given. I understand that I am entering into this financial commitment on my own free will. I understand that if I voluntarily or am asked to leave the program I am still financially responsible for payment of all unpaid fees and fees due until the end of the contract. Available Discounts: Sibling Discount o Highest Level Athlete Full Price o Second Athlete $50 off per month o Third Athlete Allstar Fees only Military Discount o 10% off each month of training fees Referral Discount o $50 per month (1 referral per athlete if referred athlete leaves the program for any reason the discount will be discontinued) Paid in Full Discount o 10% off total of training fees Signature: Date: 8

9 Credit Card Authorization Form Name as it appears on Card: Billing Address: Street: City: State: Zip Code: Type of Card: Card Number: Exp Date: CVC Code: Signature: Date: Cheerleaders Name Associated with Card: Account payments are due on the first of the month. Payment is expected before the 15 th. Your Credit/Debit Card will be charged each month for any outstanding balance on the 16 th. Non Payment and/or a declined credit/debit card payment will result in an additional $25 fee and athlete sitting out. **If your card information changes, it is your responsibility to provide the office with the most updated information. 9

10 Monthly Payment Method An invoice will be sent for monthly tuition via automatically on the first of each month. Additional invoices will also be sent, as due, for boosters, membership, uniform, season end competitions, etc. Late fees will still apply for delinquent payments. The following options are made available to make your payments. Please indicate which method you will use to make your payments: Cash/Check/Credit or Debit in person (Monthly) plus an additional 3% administrative fee Credit/Debit paid by the automatic invoice via the link provided in the Credit or Debit Monthly Automatic Withdraw (tuition, boosters, membership, uniform, season end competitions) If you chose the automatic withdraw method, please provide the following information below. Please note that this will be the card that will remain on file and will be charged between the 1 st and 15 th of each month during the months of June 2018 through April If this information changes, it is your responsibility to let the office know. Name as it appears on Card: Billing Address: Street: City: State: Zip Code: Type of Card: Card Number: Exp Date: CVC Code: Signature: Date: Cheerleaders Name Associated with Card: 10