Waiver Form

I. RISKS/PRECAUTIONS

I am aware of the risks involved with co-ed stunting, gymnastics, and cheerleading. I am aware that there is a greater than normal risk of catastrophic occurrence when participating in these activities.  I will take all of the necessary precautions of warming up and stretching before participating in the Winona State University Cheer Tryouts.

If an injury should occur, I, ___________________________, will take full responsibilities for any medical supervision or care that may be necessary.

II. WAIVER OF LIABILITY
I, _______________________________, will not hold Winona State University, Winona State Cheerleading, Winona State Team Coach's, other Winona State Cheerleaders, or Kidsport Tumble Gym financially liable for any injury incurred while cheering. Further, I will follow the rules governing the current Winona State University Cheerleading Team in that I will not consume any alcoholic beverages, nicotine, or non-therapeutic drugs on the days of tryouts or any time I am representing Winona State University as a Cheerleader.

I have the read the above information in its entirety. I understand that Winona State University, Winona State Cheerleading, Winona State Team Coachs and members, or Kidsport Tumble Gym are not liable for any injuries sustained in this event or any other organizational event. I hereby give my consent to participating in the Winona State University Cheerleading Tryouts.

X__________________________________________
Participant's Signature (or legal guardian)

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Date

III. INSURANCE INFORMATION

Name of Insurance Company: ____________________
___________________________________________
Policy Number: _______________________________

I certify that I am covered by the above listed insurance company by signing below.

X__________________________________________
Participant's Signature

X__________________________________________
Parent's Signature ( if participant is under 18)

X__________________________________________
Witness' Signature

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Date