CLASSIC All-STAR

PARTIES

1368 Piney Green Road *Jacksonville, NC 28540*(910)346-3402

WAIVER/RELEASE FORM

Date of party: ___/___/___ Time of Party __:___am/pm

Consent for Minor/Assumption of Risk Statement/Agreement:

I/we fully understand and will inform the minor participant that there are risks and dangers associated with participation in classic all-star/tumble/cheer events and activities including but not limited to bodily injury, partial and or total disability, paralysis and even death. I/we accept and assume such risk and responsibility for the losses and/or damages proceeding such injury, however caused or alleged to be caused while whole or in part by Classic All-star Cheer & Dance and it’s employees/staff.

I/We have read the above statement/agreement/waiver and sign it voluntarily.

Parent/Guardian Signature :

 

PRINT Parent/Guardian: name:

 

Guest Name:

 

 

 

 

 

Birth date of guest:

Address:

___________________________________________

Emergency Contact:

( )______ -______(H)

( )______ -______(C)

Name: _____________________________________

Email:___________________________________

If you would like to hear about future specials, deals or offers.

 

**Please fill out all information on this waiver form. Thank you!