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 you registered for the week of January 11. 
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

                                                         
School                                             
Address City 

      
State ZipCode Home Phone

 
Age Grade

 

Birthdate 

  

Mother's Name Place of Employment

Mother's Cell # Wk # SSN or DL#

Email

Father's Name Place of Employment

Father's Cell # Wk # SSN or DL#

 Email

Relative in case of emergency    Phone

Please indicate class day and time preference here:

Please Check the Class(es) to be Attended (all classes are 1 hour per week)

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 School/Squad Class
     
2009-10 Sessions Prices
September 14 - December 11 1 Hr/wk  $260/session  3 Hrs/wk $480/session
January 11 - April 2 2 Hrs/wk $380/session  4 Hrs/wk $560/session

*There is a registration fee of $25 per session*
HALF OF SESSION FEE IS DUE BY FIRST CLASS AND REMAINDER DUE BY 15TH OF NEXT MONTH
ALL MONIES ARE NON-REFUNDABLE UPON RECEIVED REGISTRATION
PLEASE INCLUDE A $25 REGISTRATION FEE PER SESSION

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 _______________