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Parent/Guardian Name

Participant Information

Participant #1

Does Your Child Regularly Take Medication

Emergency Contact Information*

Medical Authorization and Liability Release

If any, attached hereto, are made a part of this Agreement by reference and are described as follows.

The participant shall defend, indemnify and hold Mission Cheer Academy, its officers, employees and agents harmless from and against any and all liability, loss, expense, including reasonable attorney's fees or claims for injury or damages arising out of the performance of this Agreement but only in proportion to and to the extent such liability, loss, expense, attorney's fees or claims for injury or damages are caused by or result from the negligent or intentional acts or omissions of Mission Cheer Academy, its officers, agents or employees.

The participant understands that injuries as a result of cheerleading or gymnastics and other activities are the full responsibility of the participant and are not covered in any way by Mission Cheer Academy.

In signing this Agreement, the participant accepts all responsibilities for damage, harm or injury that may occur to the participant or one invited onto the premises by the participant and that Mission Cheer Academy shall have no liability for such harm, damage or injury.  Mission Cheer Academy strives to provide the maximum in safety procedures and guidelines, and cannot assume responsibility for any accidents, injuries or illness that may occur.


Parental Consent

Parental Consent: The athlete(s) listed above has my permission to participate in the Mission Cheer Academy program. In consideration for the training and coaching provided by Mission Cheer Academy and its staff and or volunteers. I understand that my son/daughter must abide by the rules and regulations set forth by the coaches and staff. I understand that violations of any of these rules may results in removal from the classes and or events. We acknowledge and recognize that hazards are present in any athletic event and that injury may result. Mission Cheer Academy coaches, staff and volunteers will not be liable for injury that occurs during cheerleading practice, contests, or travel to and from cheerleading activities

Photo Release

I hereby grant Mission Cheer Academy permission for images of my child captured by Mission Cheer Academy coaches, owners and/or an agency they hire, through video, photo and digital camera, to be used solely for the purpose of Mission Cheer Academy's promotional material and publications, including social media posts, and waive my rights to compensation or ownership thereto.

I hereby grant Mission Cheer Academy permission to use my child'/children's names, likeness in any photograph, video or other digital media photo in any and all of its publications, including web-based publications


Thanks for submitting!

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