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Are you the parent or cheerleader? Are you the parent or cheerleader? *ParentCheerleader

Email

Cheerleader's D.O.B

Cheerleader's Full Name

Postcode

Address

Is your child currently taking any medication? Is your child currently taking any medication? *Yes (includes inhalers)No

Does your child have any medical conditions? Does your child have any medical conditions? *Yes (includes asthma, anxiety, ADHD etc)No

Please provide details of any medical conditions

Please provide details of any medications

Parent's Full Name

Relationship to Cheerleader

Mobile

Mobile Number

Date of Birth

Full Address

Postcode

Do you have any medical conditions? Do you have any medical conditions? *Yes (includes asthma, anxiety, ADHD etc)No

Do you take any medication? Do you take any medication? *Yes (includes inhalers)No

Please provide details of any medical conditions

Please provide details of any medications

Emergency Contact Name

Emergency Contact Mobile

Emergency Contact Email

Relation to You

Previous Experiences Previous Experiences *None (no experience is required anyway)DanceGymnasticsCheerleadingOther

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Trial Time Trial Time *Level 1 Tumble - Tuesday 5:30-6:30pmCheer 4 Fun - Thursday 5-6pm