Waiver

Participation Waiver

Please complete this form in full before your first session. One waiver is required per participant.

Participant Details

Participant full name *

Date of birth *

Home address *

Parent / Guardian

Parent or guardian name *

Email address *

Contact number *

Emergency Contact

Emergency contact name *

Relationship to participant *

Emergency contact number *

Medical Information

Medical conditions (write 'None' if not applicable)

Allergies and medication

GP surgery name and number

Agreements

I understand that cheerleading is a physically demanding sport and carries a risk of injury. I accept these risks on behalf of the participant. *
I confirm the participant is medically fit to take part and I have declared any relevant medical conditions below. *
I give consent for a qualified First Aider to administer first aid and, where necessary, for emergency medical treatment to be sought. *
I agree that the participant will follow all ACA gym rules, coaching instructions and the club code of conduct. *
I confirm I have read and accept the ACA Safeguarding Statement, Policies and Privacy Policy. *
I give permission for photographs and video of the participant to be used by ACA for promotional purposes (optional).
I confirm the participant will be collected promptly at the end of each session by a named responsible adult. *
I understand that fees and membership are payable in advance and are non-refundable unless otherwise agreed. *

Digital Signature

Type your full name to sign *

Date *

By submitting this form you confirm the information provided is accurate and that you have the authority to sign on behalf of the participant. See our Privacy Policy.