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First Name
Registration/Acceptance Packet
Add
Photo
Athlete’s First & Last Name: __________________________________________________
M/F (Circle one) Date of Birth: ___________________Age as of 8/31/15: _____________
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Home Phone: _________________________________ Athlete’s cell (if appl)__________________________________
Athlete Address: ________________________________________ City: _____________________ Zip: _____________
PARENTS/GUARDIANS
Last Name
Athlete’s email (if appl) will be used for primary online login:_______________________________________________
1) Name: ___________________________________________________ Relation to athlete:_____________________
Cell: ______________________________ Work:__________________________ Home:_________________________
Email: ___________________________________________ Create an additional login for athlete’s online acct? Y N
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Address (if different):_______________________________________________ City:_________________ Zip:________
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2) Name: ___________________________________________________ Relation to athlete:_____________________
Team:
Cell: ______________________________ Work:__________________________ Home:_________________________
Email: ___________________________________________ Create an additional login for athlete’s online acct? Y N
Address (if different):_______________________________________________ City:_________________ Zip:________
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Please check which program you are interested in (read descriptions in Tryout Packet first)
Prep Team (starts in November)
Limited Travel (2.0) Team
National Team
Medical Information
Primary Care Physician __________________________________________ Phone:_____________________________
Insurance Carrier: ____________________________________________ Policy Number: ________________________
Allergies: _________________________________________________________________________________________
Current medications:___________________________________ Taking For: ___________________________________
List medical conditions, previous injuries and/or physical limitations: _________________________________________
_________________________________________________________________________________________________
FOR OFFICE USE ONLY:
□ Birth Certificate
□ Credit Card on File
□ Tryout Fee: Check _______________
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Cash
□ Teamsnap
CC (Attach receipt)
□ AR
□ Adj Cost ______________________________
Golden Elite Allstars Registration Packet
Crossover:
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Registration/Acceptance Packet
Financial Agreement
Athlete’s Full Name: ___________________________________________________________________
FOR OFFICE USE:
Placement: _____________
TUITION
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Tuition is due on the 5 of each month, beginning May 5, 2015 through March 5, 2016.

Levels 3, 4, 4.2, 5: $175/month

Levels 1 & 2 : $150/month

Unlimited Tumbling: $ 50/month

Crossover tuition add on: $25/month per additional team
Circle One:
Nationals
METHOD OF PAYMENT
All families must have a valid credit card on file despite method of payment selected below.
2.0
Monthly:_______________
Unlimited:______________
Crossover:_____________
Sibling Discount:________
Total:__________________

Pay in Full: 10% off total monthly tuition Due May 7/8 (cross-over add on, if applicable, is not included)
National Team : $
Local Team: $
Prep Team: $

Monthly Auto Pay: Invoices will be emailed regarding the amount to be charged. If Golden Elite Allstars does not receive
other instructions, the credit card on file will be charged monthly tuition.

Monthly Cash or Check: I prefer to pay by check or cash each month. If my payment has not been timely received by
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Golden Elite Allstars by the 5 of the month, I authorize Golden Elite Allstars to charge the credit card I have on file to avoid
late fees.

Other Incentives/Discounts: Please check here if you qualify for any tuition discount or incentive, such as the $50 sibling
discount. Please list which discount/siblings: _________________________________________
DEBIT/CREDIT CARD # (Must have card on file regardless of payment method)

Expiration Date
Visa

Mastercard
CID (3 digit on back)
/
Cardholder Name: __________________________________________________________________________________________
Billing Address: ______________________________________________ City: _______________________ Zip: _______________
Cardholder Signature: _______________________________________________________________________________________
OTHER PAYMENT DEADLINES:
I understand that in addition to the monthly tuition outlined above, I am responsible for meeting all other payment deadlines set by
Golden Elite Allstars, now or in the future, for annual registration/practice apparel/choreography (the “cheer deposit”), uniforms, &
competition fees, including, but not limited to:
Highlighted column indicates program fees for your athlete:
Due
GEA 2.0 & Minis
Down Payment - At Registration
June 15, 2015
July 30, 2015
September 15, 2015
November 1, 2015
$500
$400
$400
$400
$245
National
Youth
$500
$400
$400
$400
$380
National
Junior – Senior
$500
$450
$450
$450
$460
WORLDS
$500
$450
$450
$450
$460
It is the responsibility of the Parent/Guardian (for athletes under the age of 18) to pay all GEA invoices on the date specified. Any tuition payment not
received by the 10th of the month will be automatically charged to the credit card GEA has on file. Any other payments not received by their designated
deadlines will be automatically charged to the credit card GEA has on file. If the credit card is rejected, a $25.00 late fee/processing fee will be assessed
to your account. Athletes whose accounts are 15 days delinquent will be benched during practices/competitions.
All fees, tuition and deposits paid are NON-REFUNDABLE.
I understand that costs incurred for travel to/from competitions & lodging, food, & the like are the responsibility of each individual family.
The above named Athlete (or his/her Parent(s) or Guardian(s) if Athlete is a minor) has read, fully understands and agrees to the Financial Obligations outlined in this
agreement.
Signature: ____________________________________________________________ Date: _______________________________
Printed Name: ________________________________________ Relationship to Athlete: __________________________________
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Golden Elite Allstars Registration Packet
Registration/Acceptance Packet
Code of Conduct
Please initial each item:
________1. I hereby pledge to provide support, care and encouragement for
my child participating in GOLDEN ELITE ALLSTAR cheerleading by
following this Parent’s Code of Conduct:
________2. I will encourage good sportsmanship by demonstrating positive
support for all cheerleaders, coaches and officials at every game, practice or
other
competitive
and
exhibition
cheerleading
events.
________3. I will place the emotional and physical wellbeing of my child
ahead of my personal desire to win.
________4. I will insist that my child play in a safe and healthy environment.
________5. I will require that my child’s coach be trained in the
responsibilities of being a competitive ALLSTAR cheerleading coach and that
the coach upholds the Coach’s Code of Ethics.
________6. I will support coaches and officials working with my child, in
order to encourage a positive and enjoyable experience for all. I also
understand that all practices are closed to parents and/or family members
and that I may drop off and pickup my child at the appropriate times.
________7. I understand that the coaching staff reserves the right to place
and/or transfer cheerleaders from team to team as they see fit.
________8. I will support a positive and pro team environment for my child at
the gym and at home. I will encourage him/her to act responsibly when using
any social media and/or posting any information about GEA, teammates,
competitions, coaches, officials and vendors regarding any cheer related
information of events(s). I will ensure that my child will never post any
negative comments or information about GEA, teammates, competetions,
coaches, officials and vendors of any cheer related event(s).
________9. I will remember that the sport of ALLSTAR Cheerleading is for
youth not adults and I will do my very best to make ALLSTAR Cheerleading
fun for my child.
_________10. I will ask my child to treat other cheerleaders, coaches, fans
and officials with respect regardless of race, sex, creed or ability.
_________11. I will help my child enjoy the ALLSTAR cheerleading
experience by doing whatever I can, such as being a respectful fan,
providing transportation, ensuring that my child attends all practices on time
and by keeping the equipment clean.
code of conduct and assume the absolute financial obligation for my/our child
to participate in this ALLSTAR Cheer program.
________13. The child named below has read, understands and agrees to
abide by the cheerleader/player code of conduct.
________14. As the parent/guardian of the child named below, I hereby give
my approval for participation in GOLDEN ELITE ALLSTAR activities for the
current season. I/We assume all risks and hazards to my child’s participation
for any claims arising out of injury to the child, including, but not limited to,
transportation to and from such activities. I/We hereby waive, release,
absolve, indemnify and agree to hold harmless GOLDEN ELITE ALLSTARS,
the local team, organizers, managers, coaches, supervisors, participants,
person(s) providing transportation and any organization this ALLSTAR Cheer
program may be affiliated with.
________15. In executing the foregoing release. I/We acknowledge that
I/We understand that our personal medical/dental insurance will remain the
primary carrier, and that insurance offered through this program is secondary
in nature and is subject to an annual deductible by the carrier. It is
understood that any claim for injury arising out of my/our child’s participation
must be reported to the designated association official within 30 days of the
date of injury. It is also understood that the proof of loss must be completed
in full and filed within 60 days of receipt by GOLDEN ELITE ALLSTARS. All
monies I/We have paid to the team do not constitute payment of insurance
coverage. I/We do indemnify GOLDEN ELITE ALLSTARS, the association
and the insurance carrier should there be statement(s) by anyone that is in
contradiction. I/We attest I/We have read and understand the terms of this
contract and any disclosure information required.
________16. I/We hereby grant authority to a qualified physician to
administer such medical treatment, as said physician deems necessary
under emergency circumstances.
________17. GOLDEN ELITE ALLSTAR Cheerleaders can participate in
other organized sports as long as it does not interfere with any of the
GOLDEN ELITE ALLSTAR practices and competitions. Attendance is
necessary to continue involvement. School sports are encouraged along
with any type of program that would help your child excel in the sport of
Cheerleading.
________18. I/We have read and understand fully the provisions of this
CODE OF ETHICS consent/release authorization, and I/We have voluntarily
signed it.
_________12. I/We have read, understand and agree, as parent/guardian of
the child listed below, to abide by the role of the parent and cheerleader’s
________________________________________________________________________
Parent’s Signature or Participant if 18 years or older
Date
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Golden Elite Allstars Registration Packet
Registration/Acceptance Packet
Parent Waiver/Photo Release
In consideration of my child/ward being allowed to participate and/or be involved in any capacity with GOLDEN ELITE ALLSTARS and its’ related events
and activities, the undersigned acknowledges and agrees that:
1. The risk of injury to my child/ward from the activities involved in this program is significant, including the potential for permanent disability and death,
and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist.
2. I AND MY SPOUSE, CHILD knowingly understand and FREELY ASSUME ALL SUCH RISKS, both known and unknown, including and ARISING
FROM THE NEGLIGENCE OF THE RELEASEES or any others, assume full responsibility for my child’s/ward’s participation.
3. I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern
in my child’s/ward’s readiness for participation and/or in the program itself, I will remove my child/ward from participation and will bring such attention to
the nearest official immediately.
4. I for myself, the legal guardian of the said child, my spouse, my child/ward, and on behalf of my/our heirs, assigns, personal representatives and next
of kin, HEREBY RELEASE AND HOLD HARMLESS, GOLDEN ELITE ALLSTARS, and any member organization that is a member of this said year, its’
directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and
lessors of premises used to conduct the event (Releasees), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to
person or property incident to my child’s/ward’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF
THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
5. I, the legal guardian of the said child, for myself, my spouse, my child’s/ward’s, and on behalf of my/our heirs, assigns, personal representatives and
next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my child’s/ward’s involvement
or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS’ TERMS, UNDERSTAND
THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Parent Signature or Participant if 18 or older
Date
Parent/Guardian Athlete Photo Release Form
Cheerleader’s Name: _______________________________________________________ Age: ________
I hereby grant permission for photographs, or video to be taken during practice, assessment, and competition related activities. I understand that this
media will be produced and used for advertising, instructional, and website purposes. I authorize GOLDEN ELITE ALLSTARS (GEA) to use my
photograph on its’ World Wide Web site or in official printed publications without further consideration, and understand that GEA has the right to crop
and/or manipulate the media at its’ discretion. I also acknowledge that GEA may choose not to use my photo at any time, but may do so at its’ own
discretion at a later date.
I also understand that once my image is posted on the GEA website, the image can be downloaded by any user with access to the images, including
outsiders and GEA staff.
Therefore, I agree to indemnify and hold harmless from any claims, GOLDEN ELITE ALLSTARS Owners and all GEA staff. GEA reserves the right to
discontinue use of the photo without notice.
I understand that I DO NOT have permission to take photographs or video for any reason. This release will supersede any previous releases on file.
Parent/Guardian Name: (Please Print) ______________________________________________________________________________________
Parent/Guardian Signature_______________________________________________________________________________________________
Address: _____________________________________________________________________________________________________________
Phone Number: ________________________________________________________ Date: ________________________________________
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Golden Elite Allstars Registration Packet