West Chicago Youth Cheerleading Organization - (West Chicago, IL)

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Wego Youth Cheer Clinic

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

* Shirt Size:

* Home Phone:

* Email:

Gender:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

* Firstname:

* Lastname:

* Email:

Home Phone:

Work Phone:

* Cell Phone:

* Emergency Contact:

* Phone:

* Relationship to Player:

Policy #:

WAIVER INFORMATION

I, the parent, legal guardian or custodian of the above named minor child, hereby acknowledge that my child/ward will be participating in the West Chicago Youth Cheerleading Organization (hereinafter "Program"). I understand that my child/ward will attend and participate in this Program, and may on occasion be provided with transportation in connection with this Program. I understand that my child/ward may be photographed for publicity purposes. I acknowledge that my child/ward is participating in all events, activities, and transportation associated with this Program at his/her own risk. I hereby represent that said minor is in good health, has no communicable diseases, and has no physical conditions that would interfere with his/her participation in this Program.
I do hereby knowingly, freely and voluntarily release, acquit, waive, discharge and covenant to hold harmless the West Chicago Youth cheerleading Organization, The City of West Chicago, The West Chicago Park District, The Community High School, any and all of its Departments, its officers, employees, agents, volunteers and their respective heirs, successors and assigns from any and all liability, claims, causes of action, suits, controversies, contracts, promises, damages, debts, costs, expenses, loss of services, compensation, judgments, executions or demands whatsoever which may be sustained by me or my child/ward directly or indirectly in connection with, or arising out of, my child's/ward's use of the City's premises, participation in Program or related events, or any associated transportation, whether he/she is participating in the Program or merely attending as a spectator or visitor of the Program, whether caused in whole or in part by negligence of the West Chicago Youth Cheerleading Organization, The City of West Chicago, The West Chicago Park District, The Community High School, any and all of its departments, its officers, employees, agents, volunteers, or otherwise.
I hereby give The West Chicago Youth Organization the right to refuse the use of its premises and the right to discontinue the Program if the organization has determined, in its sole discretion, which it is in the best interest of the organization, the Program participant, or any spectators.
I hereby give The West Chicago Youth Cheerleading Organization the authority to authorize emergency transportation and/or emergency treatment to the minor/ward. I also permit the Organizations representatives to sign all documents which are required in order to permit the emergency transportation and/or emergency treatment to the minor/ward. I further agree to indemnify the Organization for the costs associated with any emergency medical services incurred by the minor/ward.
I have read this RELEASE AND WAIVER OF LIABILITY form and fully understand its terms. I further understand that I have given up substantial rights on my own behalf and on behalf of my child/ward by signing this form and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of any and all liability to the greatest extent permitted by law and agree that if any portion of this RELEASE AND WAIVER OF LIABILITY is held to be invalid or unconstitutional, only that portion shall be voided and the remainder of this document shall continue in full legal force effect.

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