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ATHLETE INFORMATION

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Parent/Guardian 1: Cell Phone #: Email: Parent/Guardian 2: Cell Phone #: Email:

MEDICAL INFORMATION

Please list any physical/psychological limitations, KHDOWK�FRQGLWLRQV� injuries, or weakness that may affect the athlete’s participation and/or performance:

Allergies:Medications (list all):

Insurance Carrier: Policy #�3DUHQW�Social Security #� Emergency Contact #:

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Notary Seal:

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Athlete Signature:

Date:

Parent/Guardian Name (Print):

Parent/Guardian Signature:

Date:

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Are you interested in being a cross-teamer? If so, list the level(s) you are interested in�

T/Tank ________

S Bra ________

Shorts ________

V-Ro ________

Uniform Top ________ +/- ________

Uniform Mesh ________ +/- ________

Uniform Bottom ________ +/- ________

Warm-up Jacket ________ +/- ________

Warm-up Pants ________ +/- ________2

Please put a check mark ,1�7+(�&,5&/(6�21/< for skills you can currently complete safely, consistently, with good technique, and :,7+287�$�63277(5.

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Coach 2

(SWDII�RQO\�EHORZ�OLQH)D1 Comments: D2 Comments:

Stunt Position:

Beginner Forward Roll

Backward Roll

Cartwheel

Round Off

Team/Level:

Coach 1

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Fo

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p.2

Standing BHS

Jumps pause BHS

Round Off BHS

Front Handspring

Standing 2 BHS

Jumps to BHS

RO BHS Tuck

Standing Tuck

Standing BHS Tuck

Jump to BHS Tuck

RO BHS Layout

Intermediate Jumps to Forward Roll

Jumps to Backward Roll

Bridge Kick Over

Back Walkover

BHS pause BHS

BWO BHS

RO BHS Series

Front Bounder

3 Jumps to BHS Tuck

3 Jumps pause Tuck

FWO RO BHS Layout

FWO RO BHS Series

Specialty Series

Front Bounder Step Out

FHS Front Bounder

Standing 3 BHS

3 Jumps to 2 BHS

FWO RO BHS Tuck

Punch Front

Jump BHS Jump BHS

Jump BHS Step Out RO BHS Tuck

FWO RO BHS Step Out RO BHS Tuck

Punch Front Pause RO BHS Tuck

Punch Front RO BHS Layout

RO Whip BHS Layout

RO Whip Punch Layout

Jump to Standing Full

BHS Series to Double Full

Standing Specialty to Double Full

Running Specialty to Double Full

LEV

EL 1

O

O

O

O

O

O

O

LEV

EL 2

LE

VEL

3

LEV

EL 4

LE

VEL

6-7

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

RO TuckO

Standing BHS Full

Standing Full

Arabian to Full

RO BHS Double Full

O

O

O

O

O

Advanced Front Walkover

Back Walkover Series

Specialty Series

3

Please circle the two evaluation dates you will attend:

May 7 8 12 13 14 15 16

Jumps to Tuck

RO BHS Full

FWO RO BHS Full

Standing BHS Layout

RO Whip 2 BHS Full

Jumps to BHS Layout

BHS Whip BHS Layout

O

O

O

O

O

O

O

O

O

O

O

3 BHS Full

2 BHS Full

Jump 2 BHS Full

CW Full

PK ______ FH ______ TT ______ 3 Jumps ______ PK ______ FH ______ TT ______ 3 Jumps ______

Stunt Position: Team/Level:

LEV

EL 5

Athlete Name Age

TEAM MEMBER PACKET *All deposits are due by the Mandatory Parent Meeting.

! TINY LEVEL 1 ATHLETES (6 & Under) “Squirts”Non-refundable deposit + monthly payments of

$400.00 (divided into 3 payments) $110.00

Deposit includes: annual gym registration, 2 practice uniforms, competition uniform rental fee, competition routine choreography and music.

Monthly payments include: monthly tuition for team training and 2 competition registration fees.

Note: Makeup, bows, warm-up suit, sneakers, personalized backpack, and team T-shirt are billed separately. However, the only items that are mandatory are the showcase fees, bows, sneakers, and team T-shirt. “Squirts” usually attend 1-2 showcases/performances.

! FEMALE CHEER ATHLETESNon-refundable deposit Level 1 & 2 +11 monthly payments of Level 3 - 6 +11 monthly payments of

! MALE CHEER ATHLETESNon-refundable deposit + 11 monthly payments of

New Member: $500.00 $305.00 $325.00

$500.00 $275.00$305.00

New Member: $300.00 $188.00

Returning Member:

Returning Member: $300.00 $168.00

Scholarship programs may be available for boys ages 14-18 that can work in the summer.

Deposit includes: annual gym registration, team summer camp training, 2 full practice uniforms, competition routine choreography and music.

Monthly payments include: monthly tuition for team training, 1 competition uniform, 1 competition bow, 1 makeup kit, 1 pair of practice sneakers, 1 pair of competition sneakers, 1 personalized warm-up suit, 1 personalized backpack, all national competition registration fees, and all coaches’ travel expenses. Note: Travel/lodging and local/regional competitions are NOT included. All vacation/holidays are already prorated into the monthly fees.

! OPEN TEAM ATHLETES (Adult Teams)For financial commitments and practice schedules, please refer to our separate paperwork for Open Team athletes.

11

1

4

RULES AND REGULATIONS CONTRACT

I have read the Top Gun Rules and Regulations Contract available on the Top Gun website in its entirety and understand its contents. I understand the responsibility my child is undertaking by becoming a Top Gun member. I agree to fully support my child and will encourage them to fulfill their commitment. I also understand that by signing this contract I am bound to not use my child’s participation in this program as a form of punishment as I realize that it also punishes their team and the entire Top Gun program. Furthermore, I understand that being a Top Gun member is a commitment on the part of the parent as well. I realize that when representing Top Gun I must always conduct myself with class and responsibility. I understand that any athlete or parent that does not abide by the rules and regulations contained in this contract, that is consistently negative, or acts in a manner that jeopardizes the name and reputation of the Top Gun program, will be subject to removal with no refund. In addition, I agree to give Top Gun full permission to seek medical attention and/or take any actions deemed necessary including but not limited to drug testing to ensure the safety and well being of my child and those around them.

____________________________ ____________________________ _________ Athlete Name (Print) Athlete Signature Date

____________________________ ____________________________ _________ Parent Name (Print) Parent Signature Date

OFFICIAL NOTARY _________________________ DATE: ____________ SIGNATURE & SEAL

5

AUTO DEBIT AUTHORIZATION FORM

Every athlete MUST turn this form in with a voided check.

Athlete Name (Print): _______________________________________

Bank Information

Name of Bank/Financial Institution: ____________________________

Bank Routing #: ___________________________________________

Bank Account #: ___________________________________________

Name as it appears on the account: _____________________________

Address as it appears on the account:

________________________________________________

________________________________________________ (City, State, Zip)

Phone #: __________________________

Alternate #: __________________________

I have read and understand the financial policies of Top Gun Cheer and Dance Training Center, Inc. I am authorized to sign on the account listed above and I certify that all the information above is complete and accurate. I hereby authorize Top Gun Cheer and Dance Training Center, Inc. to collect payment for fees due by processing a debit to the account listed above on the first of each month. I understand that if the debit should be returned, a $25.00 returned item fee would be assessed.

Name (Print): ______________________________________

Signature: ______________________________________

For office use only:

Team: _________________

Debit: _________________

Special Instructions:

_________________________

6

PAYMENT OPTIONS AND INFORMATION

• Monthly Payments - All monthly payments are auto debited on the 1st of every month.

• Quarterly - All quarterly payments are due on the 1st of June, September, December, andMarch. Each quarterly payment is equal to the sum of 3 monthly payments with theexception of March (only 2 monthly payments).

Sibling Discount(s) - A $25.00 discount for all monthly payments will be applied to families with more than 1 child in the full All Star cheer program. There are no discounts on the deposit.