Joyful Twirlers
2023-2024 Registration Form
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Email *
A $20.00 non-refundable enrollment fee is due at the time of registration.
Student Name *
Home Phone *
Date of Birth *
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School *
Grade *
Age *
Street Address *
City *
State *
Zip Code *
Mother's/Guardian's Name *
Home Phone *
Work Phone *
Cell Phone *
Father's/Guardian's Name *
Home Phone *
Work Phone *
Cell Phone *
If returning Twirler, please list the season they started (e.g. 2019-2020 season):
E-mail address you wish to use for Joyful Twirler correspondence: *
Emergency Contact *
Phone Number *
Relationship *
Required
How did you hear about our classes *
Required
Recommended by:
Please list and special conditions or needs of the child:
Hold Harmless Agreement
I am fully aware of the risks and hazards associated with participation and use of the facilities and equipment. I authorize my child (named above) to participate in said activities and fully acknowledge the full responsibility for any risk or loss, property damage, or any personal injury that my be sustained. I further acknowledge that I have procured my own adequate insurance for such loss, damage, and injury. I agree to indemnify and hold harmless Joyful Twirlers, Inc., its volunteers and agents, from any loss, damage, or cost, including court costs and attorney's fee that they may incur due to my child's participation in said activities.
I have read the Hold Harmless Agreement and agree to the terms as set forth. *
"Signed" this day *
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Signature *
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