Registration

The registration form is a 3 step process. You must complete all 3 steps to register!

Fields marked with an asterisk (*) are required

Practice Notes

Practice will begin on 8/11 and will be T/W/TH 6PM-8PM. These practices will be on the CW Middle School front lawns. On 9/1, practice moves inside to the CW Middle School Gym. Competition squad practice will be T/W 6PM-8PM and Football Squad practice will be TH 6PM-8PM. **Flag practice will only be Tuesday and Thursday 6PM-7PM for the entire season (end of season is approximately mid-November).

Cost*

Please Note

The registration fee only covers 50% of the cost of participation. We rely upon fundraising to cover the remaining 50%. FOR THE 2020 SEASON, EACH FAMILY MUST SELL 1 Box of Hershey Candy Bars for $60.00 or choose the BUY-OUT Option for $40.00. If choosing the buy-out option payment is due now. The candy will be handed out at practice.

BUY OUT OPTION

Additional Fundraising Info

We are offering additional fundraising opportunities. After the required box of candy (or buy-out option if purchased), any additional boxes of candy sold will earn a family credit of $28. There is a 4 box limit. This credit will be refunded to you at the conclusion of the fundraiser in the form of a check. Select below how many extra boxes you would like to sell.

Extra Candy

Payment Method*

Players Registered after May 24, 2020 will be subject to a $75 late Fee

Cash
Check
PayPal

Total

$0.00

Payment Info

* Mail check made payable to CWLSCA to: Cinnomin Steiger 326 Werner St Wernersville, PA 19565 * All payments must be RECEIVED by May 24th * Registration fees after May 24th includes a $75.00 fee AND you cannot choose the fundraiser. All Payments not received by May 24th will be removed from the Registration Database.

Payment Info

You have chosen PayPal as your payment method. Once you complete this entire registration form, you will forwarded to PayPal to enter your payment information and finalize your payment.

Cheerleader Info

Name*

First Last

Date of Birth*

Grade at start of School Year in Fall 2020*

School attending in Fall 2020*

Address*

Street Address Address Line 2 City ZIP Code

Home Phone*

Shirt Size*

Emergency Contact Info

Mothers Name*

First Last

Mothers Contact Phone*

Mothers Email*

Fathers Name*

First Last

Fathers Contact Phone

Fathers Email*

Alternative Contact Name*

Alternative Contact Phone*

Alternative Contact Email*

Medical Info

Indicate specific medical allergies, chronic illnesses, or other medical conditions that coaches and medical personnel should be aware of:

Is your child allergic to any drugs? If so, what?

Does your child have any other allergies?

Does your child have or use any of the following? Check all that apply.

Asthma
Diabetes
Epilepsy
Epi-pen
Inhaler
Glasses
Contacts
Hearing Aids

Is your child on any medications? If so, what?

Does your child have any disabilities and/or special needs that we may need to be aware of?

Any additional medical information that may be helpful in a medical situation?

Parent or Guardian Authorization

In case of emergency - if family physician cannot be reached - I hereby authorize my child to be treated by Certified Emergency Personnel. (i.e. EMT/First Responder/E.R. Physician)

Physicians Name*

Physicians Phone*

Volunteer Opportunities

Conrad Weiser Little Scouts Cheerleading Association believes that the more families participate and volunteer the more fulfilling the experience is for their child. Volunteers are an essential part of our organization. Please take the time to support CWLSCA by volunteering your time! Place an X next to the volunteer opportunity that would be best suited for you and your family.

Volunteer

Please choose one or more

1 Coach
2 Assistant Coach
3 Homecoming - assist with planning and running the table at homecoming
4 Spirit Wear - help run a table at a game
5 Banquet - help with set up and break down the day of

PARENT / GUARDIAN REQUIRED AUTHORIZATION -- PLEASE "SIGN" BELOW

I, the undersigned, consent to allow my child to cheer with the Conrad Weiser Little Scouts Cheerleading Association. The CWLSCA is hereby released from any responsibility from any claim for damages, which my child or I may have because of mishap, accident, or injury in traveling to and from the playing field and while participating in any game, exhibition or practice. It is my understanding that the CWLSCA/CWCA only carries liability coverage. I understand that CWLSCA/CWCA does not carry medical insurance.

Authorized Parent or Guardian*

2020 Season Authorization Date*

PHOTO RELEASE

I hereby grant to CWLSCA and/or their legal representative, permission to use photographic portraits of my child in publications, forms, advertisements, newsletters, and websites. I waive any right I may have to approve the finished product. I hereby release CWLSCA and/or their representative, or those for whom they are acting, from any liability for any violation of any personal or proprietary right I may have in connection with the use of the above stated images.

Photo Release Authorization Name*

Photo Release Authorization Date*

PARENT CONSENT

I hereby grant CWLSCA and its volunteer coaches to obtain emergency medical care and to administer minor first aid procedures in the event of an emergency. I, the undersigned, consent to allow my child to cheer with the Conrad Weiser Little Scouts Cheerleading Association. The CWLSCA is hereby released from any responsibility from any claim for damages, which my child or I may have because of mishap, accident, or injury in traveling to and from the playing field and while participating in any game, exhibition or practice. It is my understanding that the CWLSCA/CWCA only carries liability coverage. I understand that CWLSCA/CWCA does not carry medical insurance.

Parent Consent Authorization Name*

Parent Consent Authorization Date*

Registration

Step 1 of 3

Practice Notes

Please Note

Additional Fundraising Info

Payment Info

Payment Info

Cheerleader Info

Emergency Contact Info

Medical Info

Parent or Guardian Authorization

Volunteer Opportunities

PARENT / GUARDIAN REQUIRED AUTHORIZATION -- PLEASE "SIGN" BELOW

PHOTO RELEASE

PARENT CONSENT

CODE OF CONDUCT

INHERENT RISK NOTIFICATION