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 (9-14)*Please enter a number from 9 to 14.Youth #1: School*Youth #1: Grade*Youth #1: Allergies, medical or other conditions we should know about?Youth #2: Name* Last Name First Name Youth #2: Date of Birth* Date Format: MM slash DD slash YYYY Youth #2: Age (9-14)*Please enter a number from 9 to 14.Youth #2: School*Youth #2: Grade*Youth #2: Allergies, medical or other conditions we should know about?Youth #3: Name* Last Name First Name Youth #3: Date of Birth* Date Format: MM slash DD slash YYYY Youth #3: Age (9-14)*Please enter a number from 9 to 14.Youth #3: School*Youth #3: Grade*Youth #2: Allergies, medical or other conditions we should know about?Youth #4: Name* Last Name First Name Youth #4: Date of Birth* Date Format: MM slash DD slash YYYY Youth #4: Age (9-14)*Please enter a number from 9 to 14.Youth #4: School*Youth #4: Grade*Youth #2: Allergies, medical or other conditions we should know about?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 PackagesPlease select your top 3 package choices. We will confirm your package ASAP.Game Packages* October November December January February 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, I give permission. 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, I give permission. No PERSONAL HARM: Furthermore, I agree to 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, I agree. 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, I authorize. 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, I understand. No SIGNATURE: I acknowledge that clicking on the SUBMIT button below serves as my legal signature.* Yes, I acknowledge. Thanks for submitting your application. You will be notified as soon as possible to inform you of available space and dates.EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
