Registration Form1NEW - Newtown Athletic Club

Transcription

Registration Form1NEW - Newtown Athletic Club
Rock Starz All Stars will host their annual March Madness competition formerly
known as the Cupid Cheer Challenge competition. The competition event
includes Recreation, School, and All-Star Divisions.
Who can we thank for referring your team?:___________________________________
Venue
COUNCIL ROCK HS North
62 Swamp Road
Newtown, PA
Located within minutes of Rt. 95, PA Turnpike, and Rt1
Spring floor event*
Excellent multi-level seating for Spectators & Cheerleaders
With complete Handicap accessibility
Matted warm-up area with 2 spring tumble strips
Professional sound system –Ipod, Iphone & CD compatible
Squad Divisions and Regulations
We will follow National Federation rules for high school and recreational teams.
All-star cheerleading and dance teams will follow the USASF guidelines. All routines must not exceed 2-1/2 minutes.
Timing begins w/the first beat of music or team motion. All divisions will be offered; however, we reserve the right to
add, combine, or delete divisions as needed.
Complimentary Coaches & Judges Lounge
Enjoy a few minutes to relax
Beverages & Snacks
Awards & Trophies
Trophies for all Teams
Morning and Afternoon Award Sessions
Grand Champion for each session
Unlimited Vendor Participation
Video & digital Photos
Cheer Gifts and Cheer gear
Jewelry & Accessories
Event tees
Food & Drink Concessions
Variety of food vendors
Entry fee per team $150
First to register last to compete in division
Registration will be limited
Return registration forms along with payment to:
Newtown Athletic Club
c/o Rock Starz
120 Pheasant Run
Newtown, Pa 18940
Questions please e-mail rockstarz@newtownathletic.com
www.rockstarzallstars.com
Registration Form
Division
Recreational Divisions
Ankle Biter (2nd grade and below)
PeeWee (4th grade and below)
Youth (6th grade and below)
Jr (9th grade and below)
Senior Rec (12th grade and below)
School Divisions:
Junior High (9th grade and below)
JV (11th grade and under)
Varsity (9th – 12th grade)
(Varsity division will be divided into small,
medium, and large depending on number
of teams registered)
Coed Varsity (one or more males)
*Return one form per team
# on team
_______
_______
_______
_______
_______
# male members
_______
_______
_______
_______
_______
_______
_______
_______
_______
_______
_______
_______
_______
Note: Rock Starz/PFCA reserves the right to add, combine, or delete divisions as necessary.
All-Star Divisions
All-Star divisions will be divided by small (20 and less) and large (21+) teams and by USASF levels (1,2,3,4,5,6).
Teams having one or more males must register in the coed division. Ages are as of August 31, 2013.
Tiny (5 and under)
Mini (8 and under)
Youth (11 and under)
Junior (14 and under)
Junior Coed (14 and under)
Senior (18 and under)
Senior Coed (18 and under)
International Open (ages 14 and older)
Open (17 and older)
SPECIAL NEEDS (no registration fee)
PARENT DIVISION (no registration fee)
Team Registration Fee: $150
Level
_______
_______
_______
_______
_______
_______
_______
_______
_______
# on team
_______
_______
_______
_______
_______
_______
_______
_______
_______
# male members
_______
_______
_______
_______
________
________
www.rockstarzallstars.com
Registration Form
*Return one form per team
Please print each participant’s name and age as of Aug. 31st, 2013.
Participant’s Name
Age
of Aug.
31st, 2013
(asAs of
8/31/2011)
Grade (For Rec/School Only)
A Medical Release Form must be included for each Participant Listed
You can mail with your registration or bring with you the day of the competition.
www.rockstarzallstars.com
Medical Consent & Waiver Form
Team Name: ___________________________________________________________
Cheerleader’s Full Name: _________________________________________________
Parent/Guardian Full Name: _______________________________________________
Home Address: _________________________________________________________
Home Phone: ____________________
Cell Phone: ________________________
Emergency Contact Name: _______________________________________________
Emergency Phone: _________________________
Doctor’s Name & Phone: ________________________________________________
Insurance Company: ____________________________________________________
Policy & I.D. Number: __________________________________________________
Medical Conditions (allergies to medicine, heart conditions, diabetic, etc.) _________________________
I, _____________________________, give my child, __________________________
Permission to participate in the March Madness Competition March 2nd, 2014. I am aware of the obvious risks involved in
the sport of cheerleading. I realize that all necessary precautions will be taken to prevent injury. I give my consent,
that if an accident should occur, my child will be taken to a medical facility and treated if necessary. I realize I am
responsible for payment of expenses incurred relating to my child’s medical treatment. I agree not to hold Rock
Starz All Stars or Pennsbury Falcons Cheerleading and its affiliates, Council Rock School District, and all associated
officers and staff for any injury sustained as a result of my child’s participation in this competition.
Parent/Guardian Signature__________________________________________________
A separate form is required for each cheerleader.
Please mail completed forms with registration.
Photocopy as needed.
Registration may be denied due to incomplete information or absence of form.
www.rockstarzallstars.com