Cheer Crew Application Form Please note: submitting this application does not guarantee a spot in the program. We will fill spaces as they are available.Youth InfoHow many youth applications (from the same family) are you submitting?*OneTwoThreeFourTo submit youth applications from multiple families, please fill out a separate form for each family.Youth #1: Name* Last Name First Name Youth #1: Date of Birth* Date Format: MM slash DD slash YYYY Youth #1: Age (10-15)*Please enter a number from 10 to 15.Youth #1 T-shirt Size*Please select a sizeYouth SYouth MYouth LYouth XLAdult SAdult MYouth #1: School*Youth #1: Grade*Youth #1: Allergies, medical or other conditions?Youth #2: Name* Last Name First Name Youth #2: Date of Birth* Date Format: MM slash DD slash YYYY Youth #2: Age (10-15)*Please enter a number from 10 to 15.Youth #2 T-shirt Size*Please select a sizeYouth SYouth MYouth LYouth XLAdult SAdult MYouth #2: School*Youth #2: Grade*Youth #2: Allergies, medical or other conditions?Youth #3: Name* Last Name First Name Youth #3: Date of Birth* Date Format: MM slash DD slash YYYY Youth #3: Age (10-15)*Please enter a number from 10 to 15.Youth #3 T-shirt Size*Please select a sizeYouth SYouth MYouth LYouth XLAdult SAdult MYouth #3: School*Youth #3: Grade*Youth #3: Allergies, medical or other conditions?Youth #4: Name* Last Name First Name Youth #4: Date of Birth* Date Format: MM slash DD slash YYYY Youth #4: Age (10-15)*Please enter a number from 10 to 15.Youth #4 T-shirt Size*Please select a sizeYouth SYouth MYouth LYouth XLAdult SAdult MYouth #4: School*Youth #4: Grade*Youth #4: Allergies, medical or other conditions?Guardian & Home InfoParent/Guardian #1 Name* First Last Parent/Guardian #1 Email* Parent/Guardian #1 Cell Phone*Parent/Guardian #2 Name First Last Parent/Guardian #2 Email Parent/Guardian #2 Cell PhoneHome Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Cheer Crew PackagesDue to the sporadic nature of the playoffs and to accommodate as many youth as possible, you are applying for a space to attend a playoff game. We will email you prior to the start of each playoff round with the game dates and spaces will be available first-come first-serve.Yes, I am applying to attend the playoff games!* Yes, please add me to the invite email list. Consent FormsPARTICIPATION/MEDICAL: I give permission for the youth in my care noted above, to attend and participate in this program set forth by Northumberland Youth Unlimited (YFC). I also give permission for the person(s) in charge to seek medical assistance for the youth in my care noted above in the event of accident or injury.* Yes No AGE 10+ PERMISSION TO SIGN IN/OUT: I give permission for the youth in my care noted above (age 10+), to sign him/herself in and out without a parent present. In doing so, I release Northumberland Youth Unlimited (YFC) of any responsibility after he/she signs out and leaves the building.* Yes No PERSONAL HARM: Furthermore, I do not hold Northumberland Youth Unlimited (YFC) or any of its subsidiary programs, staff, volunteers, directors or officers responsible for any harm that may occur to the youth in my care noted above as a result of his/her wilful participation in the event.* Yes No PHOTO/VIDEO: I do authorize Northumberland Youth Unlimited (YFC) to take, use and own, in perpetuity; names, photographs or video/audio recordings of the youth in my care noted above, understanding that these may be used for public promotional purpose. NYU does not sell or give away any recorded materials or personal information.* Yes No PHOTO/VIDEO: I understand that due to the public nature of a hockey game, Northumberland Youth Unlimited (YFC) cannot guarantee that the Cobourg Cougars Hockey Club or local media will not take a picture or video of the youth in my care and I will not hold Northumberland Youth Unlimited (YFC) responsible if that occurs.* Yes No SIGNATURE: I acknowledge that clicking on the SUBMIT button below serves as my legal signature.* Yes No Thanks for submitting your application. You will be notified as soon as possible to inform you of available space and dates.PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
