North Allegheny Cheerleaders
Mini Camp Application
Cheerleader’s Last Name
Date of Birth (Month/Day/Yr)
Place me with one friend:
Please circle T-Shirt Size: Child S(6-8) M(10-12)
L(14-16) or Adult S M
(shirts will be available for sizing at Registration)
By my signature(s), I (we) give approval for the above child to participate in any and all activities of the Cheerleading Mini Camp. I (we)
assume all risks and hazards incidental to the conduct of the activities. I (we) agree to release, absolve, indemnify, and hold harmless the
North Allegheny Cheerleaders and NA Cheerleading Boosters Association, its officers, directors, coaches, and supervisors in the case of injury
to our child during these activities.
Allergies or Medical History we should be aware of (include Medications)
To whom it may concern: If neither parent can be contacted in the case of injury or illness, I hereby authorize representatives of the NA
Cheerleading Boosters Association to act as my agent to secure emergency medical treatment for
a minor child for whom I am responsible, at the nearest hospital, when in the opinion of the representatives, such emergency medical
treatment is deemed appropriate during the time when my child is engaged in the camp activity. I hereby agree to hold the NA Cheerleading
Association and its representatives harmless for exercising its judgment in authorizing such emergency treatment and said representatives are
specifically authorized to sign any required medical emergency hospital treatment form on my behalf.
Refunds may be given on an individual basis minus cost incurred.
CAMP USE: REGISTRATION FEE CHECK #