Cheerz
Registration Form
Cheerz Cheerleading Academy, 1739 La Neuville Rd. Lafayette,
LA 70508
We do not mail confirmations. If there is a conflict in the day you
requested, we will call you. Just come on the day that class starts.
Wear comfortable clothes. Please fill out form completely, print, and return it to Cheerz with registration fee of $25.00
per session. *Don't forget to sign the bottom*
| Participant's Name |
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| Address | City |
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| State | ZipCode | Home Phone |
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| Age | Grade |
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Birthdate |
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| Mother's Name | Place of Employment |
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| Mother's Cell # | Wk # | SSN or DL# |
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| Father's Name | Place of Employment |
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| Father's Cell # | Wk # | SSN or DL# |
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Relative in case of emergency Phone Please indicate class day and time preference here: |
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Please Check the Class(es) to be Attended (all classes are 1 hour per week) |
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| Beginner Cheer & Tumbling 1 | Intermediate Tumbling 1 | Intermediate Cheer |
| Beginner Cheer & Tumbling 2 | Intermediate Tumbling 2 | Tryout Class Jr. High (spring session only) |
| Beginner Cheer & Tumbling 3 | Int./Adv. Tumbling | Tryout Class High School (spring session only) |
| Starz Prep (spring session only) | Advanced Tumbling 1 & 2 | School/Squad Class |
| 2011-12 Sessions | Prices | |
| September 12 - December 16 | 1 Hr/wk $260/session 3 Hrs/wk $480/session | |
| January 23 - April 13 | 2 Hrs/wk $380/session 4 Hrs/wk $560/session | |
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*There is a registration fee of $25 per
session* |
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I,
, give
my child,
,
permission to participate in Cheerz Cheerleading Academy's program.
I understand that cheerleading involves intense physical activity and the chance
of injury does exist. My child is in good health and capable of
participating in this type of activity. I release and agree to hold
harmless the Cheerz Cheerleading Academy, Inc. and it's staff from any liability
whatsoever. In case of emergency, I give Cheerz and its staff permission
to call for medical attention.
I understand that tuition is due in full by 15th of the second month of the
session regardless of attendance or withdrawal.
After this date unpaid accounts will be charged a late fee. Should this account
default, it will be
turned over to the Credit Bureau.
Parent
Signature ___________________________________
Date _______________