Waiver

Waiver PARTICIPANT

Before participating in any activities at Cali Dream Athletics,
all athletes must have a completed waiver on file.

Please review the terms below carefully and submit your form before your first class or event.

"*" indicates required fields

Parent/Guardian Name*
Address*

Child's Name*
Date Of Birth*

Emergency Contacts*
Please list to who the participant may be released in case of emergency and parent cannot be reached:
Name
Relation
Phone
 

Treatment / Publicity / Liability Release*

I authorize any licensed physician to render necessary emergency treatment for an injury or serious illness when neither parent can be reached and will assume all financial responsibility for such treatment. I acknowledge that the above participant must have his/her own Medical Insurance. I understand that cheerleading camps, competitions, practices, clinics, and gymnastics equipment have an inherent danger in participation and that injuries do occur despite all precautions and accident preventatives. I further acknowledge that each participant has elected to participate in Cali Dream at their own risk and will not hold Cali Dream employees, and/or instructors liable for any and all injuries that may occur while participating in the cheerleading. The undersigned does hereby grant Cali Dream and its successors, the unrestricted right to use the undersigned’s name, likeness, or appearance on any cheerleading or dance camp posters, calendars, photographs, try-out flyers, video material, film material, computer software, computer hardware, electronic on-line services, or other similar promotional material in any form, content or medium to promote or market Cali Dream. The undersigned does hereby expressly release and waive any demand, action, claim, license, royalty, or other forms of payment the undersigned, and his or her agents, representatives, or assigns, may have based on claims of the undersigned as to rights of privacy, publicity, notoriety or any other rights arising out of or relating to any use by Cali Dream of the undersigned’s name, likeness or appearance.

Clear Signature
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