Registration - Cheer Evolution
Transcription
Registration - Cheer Evolution
Please recycle this form after reading. Do not attach to the registration package. Registration Tips and Tricks The registration process can sometimes be hard to figure outbut with these tips and tricks it should be as simple as 1, 2, 3… 4, 5, 6, 7, 8! Complete your Registration Package: One “Registration Form” per program. For schools and programs with multiple teams, simply tick off all of the divisions being entered. One “Team Roster” per team. Please be sure to fill out the division section on each Team Roster- especially if you are a large program! One “Coaches’ Code” per program. Typically we use the following short codes when notating various divisions. Feel free to use the same codes when filling out Division sections in your registration. Divisions Short Code Examples: Large Senior 4 LS4 Tiny 1 Non Compete T1 NC Int’l Open Coed 5 IOC5 One “Athlete Waiver” per athlete. Senior Coed 4.2 SC4.2 Please notify your athletes that it is very important to fill out the Division section on the waiver. Our waivers have been designed to cover the athlete for the entire 2013-2014 season so you only need to turn in one waiver per athlete per season. Primary Novice P Nov Junior Intermediate J Int Small Senior Advanced SS Adv One Form of Payment per program/school. Collegiate Coed 6 CC 6 Our Coaches’ Code has been designed to cover the athlete for the entire 2013-2014 season so you only need to turn in one code per program per season. Payment Methods are outlined on the “Registration Form” Other Important Information Home Athletes vs Crossover Athletes If an athlete competes on two teams within the SAME school or program, this means they are a crossover athlete. This athlete will be counted as a Home Athlete on the youngest, lowest level team that they compete on. For any teams after that they will be counted as a crossover athlete. Please note that crossover athletes sometimes have an alternative rate, as noted on the “Registration Form.” 1-Run vs 2-Run Athletes Some Canadian Cheer events are two run events. This means that most teams will compete twice throughout the event. At 2-Run events, there are some divisions that only compete once. These divisions are: Tiny 1, Mini 1, All Star Prep and Non Compete divisions. At 2-Run events, teams competing in these divisions are known as 1-Run teams. Please note that 1-Run athletes have an alternative rate, as noted on the “Registration Form.” Special Needs Division Canadian Cheer events offer a Special Needs division. Please note that Special Needs teams are not required to pay registration fees. However, registration forms, team rosters, and athlete waivers are still needed. Please note that any “helpers” or “spotters” that are compete with the team on the performance floor MUST fill out an athlete waiver before competing. Filling out the Payment Section on the Registration Form Please note that where applicable specialty totals and dance totals are to be added to the total registration payment. Please remember to include HST in these payments! Cheer Registration Office Use Only Reg. Received: ___________________________________ Payment Received: _______________________________ Payment Method: ________________________________ Coaches Code: Waivers: ___________ Confirmation: ____________________________________ Big East Blast 2014 K-Rock Centre, Kingston February 1, 2014 School/Program Name: __________________________________________ Program Mascot:_____________________ Mailing Address: ___________________________________________________________________________________ Contact Person: _________________________ Email (req’d): ______________________________________________ Phone #: _________________________________________ Cell #: _________________________________________ Home Town (For announcement): __________________________________ Twitter Handle: ______________________ All Star Divisions Level 1 Level 2 Level 3 Level 4.2 Level 4 Level 5 Level 6 Tiny Mini Small Youth Small Senior Youth Youth Int’l Open Mini Small Youth Large Youth Small Youth Large Youth Small Junior Large Youth Small Junior Large Junior Large Senior Senior Coed Int’l Open* Small Junior Large Junior Junior Coed Small Junior Large Junior Junior Coed Int’l Open Coed Open* Open Coed* Small Junior Large Junior Junior Coed Int’l Open Coed* Small Senior Senior Res. Large Junior Small Senior Small Senior Open* Large Senior Small Senior Small Senior Large Senior Large Senior Large Senior Senior Coed Open Coed* Senior Coed Int’l Open* Large Senior Senior Coed Int’l Open Coed* Int’l Open Int’l Open Coed *Non USASF Divisions School Divisions Novice Intermediate Primary Junior All Star Prep Advanced Level 4 Level 6 Primary Junior Junior Small Senior Collegiate Collegiate Collegiate Small Senior Small Senior Large Senior Large Senior Large Senior Senior Coed Coed Senior Coed Non Compete Level 1 Tiny Mini Youth Junior Senior Home Athlete Crossover $40 + HST $40 + HST th th Dec 7 – Jan 3 $50 + HST $50 + HST rd th $60 + HST $60 + HST Home Athletes $_____ x _______# participants = $____________ Crossover Athletes $_____ x _______# participants = $____________ Special Needs Athletes $__0 _ x _______# participants = $____ 0.00____ Extra Coaches (First 2 free) $15.00 x _______# coaches = $____________ Subtotal = $____________ HST @ 13% = $____________ Cheer Registration Payment = $____________ If applicable: Specialty Total = $____________ If applicable: Dance Total = $____________ Total Registration Payment = $____________ Junior Mini (Level 1) Senior Parent Other Jan 4 – Jan 17 Please note: registrations will not be accepted after Jan 24 Tiny (Level 1) Special Needs Registration Fees (prices are per athlete) Early Bird Standard Late On/Before Dec 6 Level 2 th Last Minute th Jan 18 – Jan 24 th $70 + HST $70 + HST th Payment Methods _________________________________________________ Cheques are payable to Canadian Cheer Evolution 466 Speers Rd, Suite 303 Oakville, ON L6K 3W9 School/ Business Cheques accepted until 2 weeks prior to the event. Personal Cheques accepted until 3 weeks prior to the event. _________________________________________________ To pay by credit, please fill out a Credit Card Authorization Form. Charges over $1,500 will incur a 3% fee. _________________________________________________ Email money transfers can be forwarded to [email protected] with the answer to the security question attached in a separate email. Office Use Only Date Received: Notes: Big East Blast 2014 Cheer Roster Division: _______________________________________ Team Name/Mascot: ________________________________ Coaches 1) _____________________________________ 2) _______________________________________________ Additional Coaches: __________________________________________________________________________________ Please use 1 page per team. Please list any additional team members on the back of this form. Participant Name Date of Birth (DD/MM/YYYY) Male Crossover Athlete Home Athlete or Crossover Crossover Division Office Use 1. _____________________________ ___________ ___________ __________ 2. _____________________________ ___________ ___________ __________ 3. _____________________________ ___________ ___________ __________ 4. _____________________________ ___________ ___________ __________ 5. _____________________________ ___________ ___________ __________ 6. _____________________________ ___________ ___________ __________ 7. _____________________________ ___________ ___________ __________ 8. _____________________________ ___________ ___________ __________ 9. _____________________________ ___________ ___________ __________ 10. ____________________________ ___________ ___________ __________ 11. ____________________________ ___________ ___________ __________ 12. ____________________________ ___________ ___________ __________ 13. ____________________________ ___________ ___________ __________ 14. ____________________________ ___________ ___________ __________ 15. ____________________________ ___________ ___________ __________ 16. ____________________________ ___________ ___________ __________ 17. ____________________________ ___________ ___________ __________ 18. ____________________________ ___________ ___________ __________ 19. ____________________________ ___________ ___________ __________ 20. ____________________________ ___________ ___________ __________ 21. ____________________________ ___________ ___________ __________ 22. ____________________________ ___________ ___________ __________ 23. ____________________________ ___________ ___________ __________ 24. ____________________________ ___________ ___________ __________ 25. ____________________________ ___________ ___________ __________ 26. ____________________________ ___________ ___________ __________ 27. ____________________________ ___________ ___________ __________ 28. ____________________________ ___________ ___________ __________ 29. ____________________________ ___________ ___________ __________ 30. ____________________________ ___________ ___________ __________ 31. ____________________________ ___________ ___________ __________ 32. ____________________________ ___________ ___________ __________ 33. ____________________________ ___________ ___________ __________ 34. ____________________________ ___________ ___________ __________ 35. ____________________________ ___________ ___________ __________ 36. ____________________________ ___________ ___________ __________ *Athletes must be of the correct age as of Aug 31, 2013. Exception: Athletes competing in Int’l Open 5 and 6 divisions must be of the correct age category as of Dec 31, 2014. CANADIAN CHEER WAIVER 2013-2014 *Please note that each individual athlete must submit a completed waiver. Only one waiver form must be signed per athlete, per season Participant Name: Parent/Legal Guardian Name: Address: Daytime Phone: City/Prov/Code: Evening Phone: Email: Cell Phone: Program (School/Gym) : Division: RELEASE OF LIABILITY It is a condition of competing in any of the 2013/2014 Cheer Evolution Events that this form is fully completed, signed and submitted. It is a condition of competing in any of the 2013/2014 Cheer for the Cure Events that this form is fully completed, signed and submitted. The Parent/Legal Guardian named above certifies that he or she has full authority with respect to the care, control and custody of the Participant and understands that the Releasees are relying on this certification. The Participant and/or the Parent/Legal Guardian gives permission for and consents to the Participant competing in the Event(s). In consideration of allowing the Participant to compete in the Event(s), the Parent/Legal Guardian named above hereby releases 7666705 Canada Inc. (Cheer Evolution) and/or 6763201 Canada Inc. (Cheer for the Cure) as the hosting bodies and host venue(s) (school, university, arena, hotel, convention centre, etc.), any and all sponsors of the Event(s), all vendors at the Event(s) (collectively the "Releasees") and all of the directors, officers, employees, sub-contractors, agents or representatives of each of the Releasees from any and all liability whatsoever from any claim, demand, action or cause of action of any kind arising from any illness, injury of any kind or death of the Participant as a result of or caused directly or indirectly by the Participant attending or competing in the Event(s). The Participant and/or the Parent/Legal Guardian further agrees to indemnify and save harmless all persons covered by this Release and their successors, assigns or personal representatives from any claims, demands, actions or causes of action brought against them by the Participant or any other person in any way related to the Participant attending or competing in the Event(s). This indemnity extends to and includes all costs, legal or otherwise, incurred in defending any such claim, demand, action or cause of action. The Parent/Legal Guardian further acknowledges that it is his or her sole responsibility to ensure the Participant is properly supervised and chaperoned at all times during the Event(s) as part of the program with which they are competing. The Releasees have no obligation in this regard. MEDICAL RELEASE The Participant and/or the Parent/Legal Guardian hereby certifies that the Participant does not suffer from any physical disability or medical condition which would pose a risk to the Participant while attending or competing in any Cheer Evolution Event(s) in the 2013/2014 season and understands that Cheer Evolution and/or Cheer for the Cure is/are relying on this certification. The Parent/Legal Guardian acknowledges that there is a risk to the Participant of sustaining an injury (minor, serious, catastrophic or fatal) by reason of attending or competing in the Event(s). The Parent/Legal Guardian, on his or her own behalf and on behalf of the Participant, hereby assume all responsibility for any such risk and releases Cheer Evolution and/or Cheer for the Cure as the hosting bodies, the host venue and any sponsors of the Event(s), from any claim, demand, action or cause of action of any kind with respect to such injury. Notwithstanding that Cheer Evolution and/or Cheer for the Cure, has no obligation to do so; the Parent/Legal Guardian authorizes Cheer Evolution and/or Cheer for the Cure to provide treatment for the Participant in the event of an injury. If no medical treatment is provided, or if the provided treatment is ineffective, Cheer Evolution and/or Cheer for the Cure will not be liable in any way. The Parent/Legal Guardian shall be responsible for all costs of any such treatment and indemnifies and holds harmless, Cheer Evolution and/or Cheer for the Cure or its agents in this regard. USE OF IMAGES OR RECORDINGS OF THE EVENTS The Participant and/or the Parent/Legal Guardian acknowledge that Cheer Evolution and/or Cheer for the Cure and its affiliates or contracting companies, from time to time produces photographs, videotapes, DVD's, podcasts and video casts recording activities at the Event(s) to be used for promotional or other commercial purposes. The Parent/Legal Guardian, on his or her own behalf and on behalf of the Participant, acknowledge that the Participant may be included in such recordings as a participant or spectator at the Event(s) and consents to same. The Participant and/or the Parent/Legal Guardian hereby transfers and assigns to Cheer Evolution and/or Cheer for the Cure and its successors, the exclusive right to make such recordings and utilize the Participant's image and/or voice for the purposes of Cheer Evolution for the Event(s), for any future Event(s), for advertising and promotion in general or for any other commercial purpose. The Participant and/or the Parent/Legal Guardian waives any right to monitor, inspect or approve any such recordings or the use of any such recordings. The Participant and/or the Parent/Legal Guardian confirms that he or she has read this document in its entirety and fully understands the contents and is signing it voluntarily in order that it can be relied upon by the Releasees. Nothing in this document guarantees the Event(s) will take place. I have read, understand and agree to abide by all terms and conditions outlined on this form. (Date) _____________________________________________________ Signature of Parent/Legal Guardian (Date) _____________________________________________________ Signature of Participant CANADIAN CHEER WAIVER 2013-2014 *Veuillez noter que chaque athlete doit soumettre un formulaire de renonciation dûment rempli. Un seul formulaire de renonciation doit être signé par athlète, par saison. Nom Participant(e): Nom Parent/ Tuteur légal: Adress: Numéro de téléphone (Journée): Ville/Prov/Code: Numéro de téléphone (Soiré): Courriel: Téléphone cellulaire: Programme (École/Gymnase) : Division: DÉGAGEMENT DE RESPONSABILITÉ Afin de participer á la/aux compétition(s) de Cheer Evolution 2013/2014, ce formulare doit être rempli complement, signé et soumis. Afin de participer á la/aux compétition(s) de Cheer for the Cure 2013/2014, ce formulare doit être rempli complement, signé et soumis. Le parent/tuteur légal nommé plus haut certifie qu'il ou elle a toute autorité en ce qui concerne les soins, let contrôle et la garde du/de la participant(e) et reconnaît que les renonciataires se fondent sur cette attestation. Le/la participant(e) ou le parent/tuteur légal autorise le/la participant(e) à prendre part à la/aux compétition(s) et consent à ce qu'il/elle y participe. En contrepartie de l'autorisation du/de la participant(e) à prendre part à la/aux compétition(s), le parent/tuteur légal nommé plus haut dégage par la présente 7666705 Canada Inc. (Cheer Evolution) et/out 6764301 Canada Inc. (Cheer for the Cure), les organismes hôte et le(s) site(s) hôte(s) (école, université, stade, hôtel, centre de congrès, etc.), chacun et tous les patronages, les commanditaires de la/des compétition(s), tous les fournisseurs de la/des compétition(s) (collectivement les <renonciataires>) et tous les directeurs, les membres de la direction, les employés, les sous-traitants, les mandataires ou les représentants de chacun des renonciataires de toute responsabilité quant à toute blessure ou décès du/de la participant(e) découlant de ou causé directement ou indirectement par la participation ou la présence du/de participant(e) à la/aux compétition(s). Le/la participant(e) ou le parent/tuteur légal accepte également d'exonérer de toute responsabilité toutes le personnes couvertes par le présent dégagement et leurs successeurs, ayants droit ou représentants personnels de toute réclamation, demande, action ou cause d'action déposée contre eux par de/la participant(e) ou toute autre personne liée d'une façon ou d'une autre à la participation ou la présence du/de la participant(e) à la/aux compétition(s). Cette exonération s'applique à tous les frais, juridiques ou autres, engagés pour la défense d'une telle réclamation, demand, action ou cause d'action. Le parent/tuteur légal reconnaît également qu'il relève de sa seul responsabilité de s'assurer que le/la participant(e) est correctment supervisé(e) à tout moment pendant la/les compétition(s) dans le cadre du programme auquel il ou elle participe. Les renonciataires n'ont aucune obligation à cet égarde DÉCHARGE MÉDICALE Le/la participant(e) ou le parent/tuteur légal certifie par la présente que le/la participant(e) ne souffre d'aucune incapacité physique ou d'aucun problème de santé qui induirait un risque pour le/la participant(e) lors de sa présence ou de sa participation à la/aux compétition(s) de Cheer Evolution et/ou Cheer for the Cure pendant la saison 2013/2014 et reconnaît que Cheer Evolution et/ou Cheer for the Cure se fonde sur cette déclaration. Le parent/tuteur légal reconnaît qu'ill exist un risque que le/la participant(e) puisse subir une blessure (légère, grave, catastrophique ou fatale) lors de sa présence ou de sa participation à la/aux compétition(s). Le parent/tuteur légal, en son nom propre et au nom du/de la participant(e), assume par la présente toutes les reponsabilités liées à ce risque et tient indemnes Cheer Evolution et/ou Cheer for the Cure, l'organisme hôte, le site hôte et tout commanditaire de la/des compétition(s) de toute réclamation, demande, action ou cause d'action quelle qu'elle soit concernant une telle blessure. Nonobstant le fait que Cheer Evolution et/ou Cheer for the Cure n'a aucune obliation de le faire, le parent/tuteur légal autorise Cheer Evolution et/ou Cheer for the Cure à fournir un traitement qui peut s'avérer nécessaire au/á la participant(e) en cas de blessure. Si aucun tratement n'est fourni, ou si le traitement fourni n'est pas efficace, Cheer Evolution et/ou Cheer for the Cure ne sera en aucun cas tenu responsable. Le parent/tuteur légal est responsable de tous les frais liés à un tel traitement et exonère de toute responsabilité Cheer Evolution, Cheer for the Cure, ou ses mandataires à cet égard. UTILISATION DES IMAGES OU DES ENREGISTREMENTS DES COMPÉTITIONS Le/la participant(e) ou le parent/tuteur légal reconnaît que Cheer Evolution et/ou Cheer for the Cure et ses compagnies affiliées ou contractantes, produisent de temps à autre des photographies, des enregistrements vidéo, des DVD, des balados audio et vidéo des activités de la/des compétition(s) à des fins d'utilisation promotionnelle ou à d'autres fins commerciales. Le parent/tuteur légal, reconnaît en son nom propre et au nom du/de la participant(e) que le/la participant(e) peut apparaître sur de tels enregistrements en tant que participant(e) ou spectateur/spectatrice à la/aux compétition(s) et y consent. Le/La participant(e) ou le parent/tuteur légal trasfère et cède à Cheer Evolution, Cheer for the Cure et à ses successeurs le droit exclusif de réaliser de tels enregistrements et d'utiliser l'image ou la voix du/de la participant(e) pour les besoins de Cheer Evolution et/ou Cheer for the Cure, pour toute compétition à venir, à des fins de publicité et de promotion en général ou à tout autre fin commerciale. Le/la participant(e) ou le parent/tuteur légal renonce à ses droits de contrôler, d'examiner ou d'approuver de tels enregistrements ou l'utilisation de tels enregistrements. Le/la participant(e) ou le parent/tuteur légal confirme qu'ill ou elle a lu ce document dans son intégralité, a pleinement compris son contenu et le signe volontairement de sorte que les renonciataires peuvent s'appuyer dessus. Rien dans ce document ne garantit que la/les compétition(s) aura/auront lieu. J'ai lu, compris et accepte de me conformer à toutes les conditions indiquées dans ce formulaire. (Date) _____________________________________________________ Signature du parent/tuteur légal (Date) _____________________________________________________ Signature du/de la participant(e) Canadian Cheer Coaches Honour Code 2013-2014 • • • • • • • • • • • • This Competition is being administered by CANADIAN CHEER. The judges will make all final decisions on the placing of each team (this includes deduction and disqualification penalties). The decision of the judges is FINAL and is not open to discussion. The COACH is responsible for adherence to all rules listed in the General Guidelines and Policies and Registrations. The guidelines are set forth on the CANADIAN CHEER Website, www.canadiancheer.com I further acknowledge that CANADIAN CHEER uses a levelling system for their competition divisions. I am aware of the rules pertaining to each division, and agree to abide by them. I take full responsibility for knowing the rules and limitations for each division. The COACH, team, and fans of the team (i.e. Parents/Spectators) will demonstrate appropriate sportsmanship before, during, and after the competition. The COACH acknowledges that all participants on the team are eligible for the division entered. Ineligible participants will result in team disqualification. The COACH acknowledges that all participants are entered on the official roster and any changes to this roster have been made known to CANADIAN CHEER. The COACH of each team will assume responsibility for the safety, well-being and conduct of all their corresponding team members. The COACH understands the policies regarding image and crossovers as stated by the USASF/IASF and will endeavour to the best of their ability to ensure their members follow these guidelines. The COACH acknowledges communicating all the above information to all team members, other coaches, parents, supporters and other involved persons. All cheerleaders named on all rosters are currently and legitimately enrolled in the school or organization named and will be on the day of the competition. I also verify that all athletes meet the age and eligibility requirements for the division for which we are registering. All-Star/Club teams must hold a current liability policy of at least $2 million, which covers all athletes and coaches from that specific club. School teams must be covered by their school board insurance policy for off-site participation or must hold a separate liability policy of at least $2 million specific to the team. All cheerleaders participating with our program are representing the School or All-Star Club and are covered by the Canadian Cheer insurance requirements noted above. FAILURE TO ADHERE TO ANY OF THE ABOVE MAY RESULT IN PENALTIES, AND/OR THE ENTIRE TEAM BEING DISMISSED FROM THE COMPETITION. I fully agree to the responsibilities, terms and conditions listed above: Coach Signature: ________________________________________ Date: ____________________ Printed Coach Name: ______________________________________________________________ Staff Advisor Signature: ___________________________________ Date: ____________________ (School Teams Only) Printed Staff Name: ________________________________________________________________ School/Organization: _______________________________________________________________ * Staff advisor section must be signed for all school teams including University and College teams. If the team staff advisor is also the team coach, that person must complete both sections of the form. Canadian Cheer Code D’Honneur des Entraineurs 2013-2014 • • • • • • • • • • • Cette compétition est administrée par CANADIAN CHEER. Les juges prendront toutes les décisions définitives sur le classement de chaque équipe (cela comprend les sanctions de déduction de points ou de disqualification). La décision des juges est DÉFINITIVE et ne saurait être discutée. L'ENTRAÎNEUR est responsable du respect de toutes les règles stipulées dans les lignes directrices, les politiques et au moment des inscriptions. Les lignes directrices sont disponibles sur le site Web de CANADIANCHEER:www.canadiancheer.com Je reconnais que CANADIANCHEER utilise un système de niveau pour les divisions de compétition. Je suis au courant des règles de chaque division et j'accepte de les respecter. Je prends l'entière responsabilité de la connaissance des règles et des restrictions pour chaque division. L'ENTRAÎNEUR, l'équipe et ses partisans (par exemple les parents ou les spectateurs) feront preuve d'un esprit sportif approprié avant, pendant et après la compétition. L'ENTRAÎNEUR atteste que tous les membres de l'équipe remplissent les conditions requises pour la division dans laquelle ils sont inscrits. La présence de participant(e)s qui ne remplissent pas les conditions entraînera la disqualification de l'équipe. L'ENTRAÎNEUR atteste que tous/toutes les participant(e)s sont mentionné(e)s dans la liste des joueurs et que CANADIANCHEER a été informé de tout changement dans la liste des joueurs. L'ENTRAÎNEUR de chaque équipe assumera la responsabilité de la sécurité, du bien-être et du comportement de tous les membres de son équipe. L'ENTRAÎNEUR certifie avoir transmis toutes les informations ci-dessus à tous les membres de son équipe, aux autres entraîneurs, aux parents, aux partisans et aux autres personnes concernées. Tous/toutes les meneurs/meneuses de claque cité(e)s dans la liste des joueurs sont actuellement et légitimement inscrit(e)s dans l'école ou l'organisme mentionné et le seront le jour de la compétition. Je confirme également que tous/toutes les athlètes ont l'âge requis et remplissent les conditions requises pour la division dans laquelle ils/elles sont inscrit(e)s Les équipes de clubs/d'étoiles doivent être en possession d'une police d'assurance de responsabilité civile en cours de validité d'au moins 2 millions de dollars qui couvre tous/toutes les athlètes et les entraîneurs de ce club. Les équipes scolaires doivent être couvertes par la police d'assurance de leur conseil scolaire pour des participations à l'extérieur ou doivent être en possession d'une police d'assurance de responsabilité civile d'au moins 2 millions de dollars spécifique à l'équipe. Tous/toutes les meneurs/meneuses de claque participant à notre programme représentent le club scolaire ou d'étoiles et sont en conformité avec les exigences en matière d'assurance de Canadian Cheer mentionnées plus haut. TOUT MANQUEMENT AU RESPECT DES RÈGLES CI-DESSUS PEUT ENTRAÎNER DES SANCTIONS OU LA DISQUALIFICATION DE TOUTE L'ÉQUIPE DE LA COMPÉTITION. J'accepte toutes les responsabilités et les conditions indiquées plus haut : Signature de l'entraîneur : __________________________________ Date: ____________________ Nom de l'entraîneur en caractères d'imprimerie : __________________________________________ Signature du conseiller : _______________________________________ Date: ____________________ (Équipes scolaires uniquement) Nom du conseiller en caractères d'imprimerie : ___________________________________________ École/Organisme : _________________________________________________________________ Canadian Cheer Credit Card Authorization Form FOR OFFICE USE ONLY School/Club Name: ________________________________________________ Event (Name & Date): ___________________________________________ Contact Name: ___________________________________________________ Phone: ___________________ Email: _________________________________ Type of Credit Card (Please check one): Visa Master Card Credit Card Number: _______________________________________________ Expiry Date: _______________ Security Number: ________________________ (Last 3 digits located on the back of the card by the signature) Name as it appears on card: _________________________________________ I hereby authorize Canadian Cheer to process the amount indicated on the attached registration form to the Credit Card as indicated above. Signature: _____________________________ Date: ____________________ Upcoming Competitions Get the best price! Register before the Early Bird Deadline! For more information visit www.canadiancheer.com Join over 185 teams in the battle for the provincial title. Don’t miss the World’s Showcase, where the top level 5 & 6 teams from around Ontario vie for Partial Paid and At Large bids to the 2014 Cheerleading World Championships. May 10 or 11, 2014 Powerade Centre, Mississauga Cheer Dance Specialty 1-Run Solo Duet/Trio Group Indy Duo/Stunt Early Bird th (On/Before Dec 13 ) Standard th th (Dec 14 – Jan 10 ) Late th th (Jan 11 - Jan 24 ) Last Minute th st (Jan 25 – Jan 31 ) $40 + HST $50 + HST $60 + HST $70 + HST $45 + HST $65 + HST $43 + HST $63 + HST $40 + HST $60 + HST $45 + HST $35 + HST Over 360 teams from across Canada and the U.S. vie for the National title, don’t miss the MOST prestigious event in the nation. Offering school, allstar, demo, dance and specialty cheer divisions, this is the pinnacle of the season. From our amazing staging to our signature awards ceremony, every second is designed to make each and every athlete feel like all the sacrifice and practice has been worth the effort. Join the best teams in the nation and hit up all the touristy fun of Niagara at the 2014 Canadian Cheer & Dance Nationals! April 11-13, 2014 Scotiabank Centre, Niagara Falls Cheer Dance Specialty 1-Run 2-Run Crossover Solo Duet/Trio Group Crossover Indy Duo/Stunt Early Bird th (On/Before Jan 24 ) Standard th th (Jan 25 – Feb 28 ) Late st th (Mar 1 - Mar 14 ) Last Minute th st (Mar 15 – Mar 21 ) $75 + HST $85 + HST $100 + HST $120 + HST $95 + HST $110 + HST $140 + HST $165 + HST $60 + HST $70 + HST $90 + HST $105 + HST $85 + HST $120 + HST $80 + HST $110 + HST $75 + HST $100 + HST $70 + HST $90 + HST $85 + HST $70 + HST (Prices listed are for “Full Event Package”)