CHEERLEADING 2023
If you have any questions please contact: Stacy Hollon at dcaacheercommissioner@gmail.com
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Players Full Name *
Date of Birth *
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DD
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YYYY
Players Gender *
Grade Enrolled   *
Players Address *
Parent/Guardian #1 Name *
Parent/Guardian #1 Address  
Parent/Guardian #1 Phone number *
Parent/Guardian #1 email address *
Parent/Guardian #2 Name
Parent/Guardian #2 Address
If different from player
Parent/Guardian #2 phone number
Parent/Guardian #2 email address
Are you interested in Coaching?
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Emergency Contact *
Other than parent/guardian
Emergency Contact number *
Allergies or Limitations *
Method of Payment *
Participation fee is $80.00 and is due before the first game.
Shirt Size *
Skirt Size *
SPORTSMANSHIP/PHOTO RELEASE
Sportsmanship is critical to the success of all DCAA programs. This is true of players, coaches, parents and spectators at every game, practice or other sporting event. Any issues with coaches should be addressed privately and in a respectful manner at an agreed upon time and place away from the game field/floor. Referees/umpires should not be yelled at or taunted. Above all, it is essential that we be positive role models and set the best examples for the young ones we influence. Failure to adhere to these principles of conduct may result in expulsion from an event and continued violations could result in the dismissal of the child from the team.

I understand that the DCAA or its designee has my permission to take photos and/or videos of myself or my child during program activities and events for use in print publication, online publication, presentations, websites, and social media. I also understand that no royalty, fee or other compensation became payable to me by reason of such use.
Parent/Guardian Signature *
In agreeing below, I and my student athlete understand and agree to the above stated sportsmanship guidelines. We will make every effort to represent DCAA and its programs in the most positive way.
RELEASE, WAIVER OF LIABILITY AND COVENANT NOT TO SUE
IN CONSIDERATION OF my child/ward, being allowed to participate in any way in Dansville Community Athletic Association (DCAA) related events and activities, I, as the parent or guardian, the undersigned acknowledge, and agree that:

The risk of injury to my child from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

1) FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PARTICIPANTS, spectators, administrators, or others, and assume full responsibility for my child’s participation; and

2) I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for and/or participation in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately; and

3) I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY, RELEASE AND HOLD HARMLESS Dansville Community Athletic Association (DCAA); its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event, WITH RESPECT TO ANY AND ALL LIABILITIES, INCIDENTS, INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my or my child’s/ward’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

4) It is understood and agreed that, if any provision of this release or the application thereof if held invalid, the invalidity shall not affect other provisions or applications of this release which can be given effect without the invalid provisions or applications. To this end, the provisions of this release are declared severable.

5) The language of all parts of this release shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any party. This release is the only, sole, entire, and complete agreement of the parties relating in any way to the subject matter hereof. No statements, promises, or representations have been made by any party to any other, or relied upon, and no consideration has been offered or promised, other than as may be expressly provided herein. This release supersedes any earlier written or oral understandings or agreements between the parties.


Parent/Guardian Signature *
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING, AND AGREE FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
UNDERSTANDING OF RISK
I understand the seriousness of the risks involved in participating in this program, my personal responsibilities for adhering to the rules and regulations, and accept them as a participant and I further understand that the terms of the above release apply to me and my participation in any/all Dansville Community Athletic Association (DCAA) Programs and that I have given up substantial rights in exchange for participation.
Parent Guardian Signature *
I have read the Understanding of Risk and agree
CONCUSSION INFORMATION
Please take a moment to read the concussion information sheet posted on the DCAA website. https://www.dcaa12.com/Home/concussion-information-sheet

A hard copy of this can be provided to you upon request. Please review this information with your student athlete and sign below.
Please Type Parent/Guardian Name *
I have read the concussion information sheet with my student athlete and I understand the information.
Please Type Student Athlete Name *
I have read the concussion information sheet with my parents/guardians and I understand the information.
Waiver
In the event of an injury, I understand treatment will be initiated for my child named above as soon as possible. I also understand the DCAA does not carry medical or liability insurance to cover the cost of any treatment. In agreeing below, I give permission for any medical attention necessary to be administered to my child under the direction of the coach and/or officer of the DCAA until I can be contacted and accept financial responsibility in the event that emergency personnel is called on behalf of my child. I hereby release the DCAA, its coaches, commissioners, officers and volunteers from any and all liability for personal injury or property damage resulting from my son/daughter participating in this program.
Please Type Parent/Guardian Name *
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