Hornets Cheerleading Wait List

Season 15

Season 15 of Hornets Cheerleading is now full and currently and only accepting registrations to a wait list.

If you are interested in still registering your athlete, please fill out the following information.

Should there be a new opening in the program that matches your athlete’s age and skill level, we will contact you to see if there is still an interest and ability to join us.

We are not taking a payment at the time you register on the wait list. If a spot opens up and you are able to claim it, we will send you a link to the payment system. Full payment is expected at that time. We do not offer payment plans.

PLEASE DO NOT LOSE HOPE! We pull athletes from our wait list every season, frequently before any practices even begin.

NOTE: A position on our wait list does not guarantee participation in our program.

Legal Disclaimer

PLEASE READ CAREFULLY AND INDICATE YOUR AGREEMENT BELOW. NOTE: THIS FORM INCLUDES A RELEASE OF LIABILITY.

AUTHORIZATION AND RELEASE OF LIABILITY

I, the parent or guardian of the named child, authorize the participation of my child in the Hebron Baptist Church/Impact Cheerleading season. I understand that this program is a nonprofit Christian sports ministry program for youth and that my child’s participation is voluntary and not essential to completion of requirements of any program, school or government agency. I understand that Impact Cheerleading is conducted by Impact Cheerleading Staff and Hebron Baptist Church volunteers. I further understand and agree that my child’s participation in athletic and other cheerleading activities necessarily involves the risk of injury and even death from various causes, including but not limited to accidents, falls, strenuous and prolonged physical activity, dehydration, illness, collision or dispute with other participants. On behalf of my child, me and my family, I assume these risks. In consideration of the privilege of my child’s participation in cheerleading, and on behalf of my child and me as a parent/guardian, I hereby release, discharge, hold harmless and indemnify, and covenant not to sue Hebron Baptist Church or Impact Cheerleading, and all of the church’s and Impact’s directors, officers, elders, deacons, employees and all other persons associated with cheerleading as to any and all claims of my child, me and other family members for personal injuries suffered by my child, property damage, medical expenses and economic loss arising directly or indirectly out of my child’s participation in cheerleading, and any first aid, medical care or treatment provided to my child in the event my child is injured or becomes ill while participating in cheerleading activities, and excepting claims that may not be released under applicable law. This Release of Liability shall be as broadly construed as allowed by law to include all claims and rights that the child, that I as a parent/guardian, and that other family members may have. I am a legally responsible parent or guardian of my child. If any provision of this Release of Liability is deemed invalid, the remaining provisions shall remain in full force and effect. This Release of Liability shall be binding on me, my family, heirs, next of kin, legal representatives, beneficiaries, successors and assigns. I give permission for free use of my child’s name and picture in broadcasts, telecasts or written accounts for any participation in an FCC/Impact activity.

FULL DISCLOSURE

I attest that I am fully disclosing any and all current or past medical or developmental diagnosis or interventional assistance for my child. If a known condition or diagnosis is discovered that was not disclosed to Hornets Leadership or Hebron Baptist Church staff, I understand that participation in Hornets Cheerleading will be forfeited with no refund.

MEDICAL CONDITIONS

I understand that participation in cheerleading may involve strenuous and prolonged physical activity. I agree that my child is healthy and able to participate in the activities. I understand that Hebron Baptist Church or Impact may request health information concerning my child and/or ask my child to undergo a medical exam. If the church/Impact determines my child unable to participate in cheerleading activities, I understand and agree that they might have to make certain decisions out of the concerns and best interests of my child and other participants.

CONSENT TO MEDICAL TREATMENT

In the event my child is injured or becomes ill during cheerleading activities, and if I, the parent or guardian of the named child, am not able to make medical decisions, I hereby authorize the church, staff and Impact to arrange for and consent on my behalf to emergency medical and dental care and treatment, including test(s), and radiological exams and surgery and hospital care and treatment, and to consent to medications for pain and other conditions as prescribed by medical personnel attending my child. I am responsible for payment of any medical charges and expenses not covered by my insurance or the insurance applicable to my child. My signature below indicates that all information provided in this form is true and accurate, and that I fully agree to all statements made on the form, including but not limited to the Authorization and Release of Liability, Medical Conditions, and Consent to Medical Treatment. Each responsible parent/guardian should sign.

PHOTO WAIVER

I understand that Hornets Cheerleading regularly takes and uses photos of events throughout the season on our website, Facebook page, and/or promotional materials. Note: If you have concerns about the use of images of your child, please make Hornets Cheerleading aware of this and every effort will be made to keep their images from being used.

    I have read and agree to the legal disclaimer and waiver above.

    Registrant Information

    Note: If you are registering more than one cheerleader, please complete this registration form again, separately, for each cheerleader you wish to register.

    PARENT/GUARDIAN INFORMATION

    Who should serve as the primary contact for Hornets communications?

    Mother/Guardian First Name

    Mother/Guardian Last Name

    Mother/Guardian Email Address

    Mother/Guardian Phone Number

    Father/Guardian First Name

    Father/Guardian Last Name

    Father/Guardian Email Address

    Father/Guardian Phone Number

    Insurance Company

    Insurance Policy Number

    EMERGENCY CONTACT (someone other than parent/guardian)

    Emergency Contact Name

    Emergency Contact Number

    CHEERLEADER INFORMATION

    Cheerleader First Name

    Cheerleader Last Name

    Cheerleader Email Address (if any)

    Cheerleader Phone Number

    Street Address

    City

    Zipcode

    How old will your cheerleader be on December 31, 2021?

    Cheerleader date of birth

    Name of school/college during 2021-2022 school year?

    Will this cheerleader be graduating from High School during the 2021-2022 season?

    CHEERLEADING EXPERIENCE

    ALL SKILLS LISTED BELOW WILL BE VERIFIED DURING OUR MANDATORY EVALUATIONS.

    Has your athlete ever cheered before? If so, what type of cheerleading was it? Choose all that apply.

    If your cheerleader has prior cheerleading experience, please choose all of the cheerleading positions your athlete has experience with? Choose all that apply.

    Tumbling Experience (Please ONLY indicate skills that your cheerleader can perform during a full-out routine with music, on a non-spring floor and without spotters)

    Will your cheerleader be participating with any other cheerleading or sports programs during the Hornets season?

    VACATION DATES

    If you have made reservations for family or work vacations or mission trips already, please list those dates here.

    Note: This information aids coaches with their practice plans in order to accommodate known absences, ensure the most productive practice(s) possible.

    Please list all vacation dates

    MISCELLANEOUS INFORMATION

    Has the cheerleader ever received any special needs/intervention/ resource services?

    If “Yes”, please provide us with details

    Has the cheerleader ever had an IEP (Individualized Education Plan)?

    If “Yes”, please provide us with details

    Please list any known allergies or medical concerns that are important for Hornets leadership to know about.

    WAIT LIST CONFIRMATION

    In order to receive a copy of your Wait List confirmation by email, please list the name and email of the responsible party below and their preferred email address.

    Email address to send confirmation of registration