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Cheerleader's Full Name

Date of Birth

Address

Town

County

Post Code

Cheerleader's Email

Cheerleader's Mobile

Do you have any known medical conditions? If so, please state (include things such as asthma)

Are you currently taking any medication? If so, please detail what it is, when it is required and the dosage. (This includes inhalers)

Emergency Contact 1 Name

Emergency Contact 1 Relationship to Cheerleader

Emergency Contact 1 Mobile Number

Emergency Contact 1 Email

Emergency Contact 1 Full Address

Emergency Contact 2 Name

Emergency Contact 2 Relationship to Cheerleader

Emergency Contact 2 Mobile Number

Emergency Contact 2 Email

Emergency Contact 2 Full Address

Any previous experience? Any previous experience? *CheerleadingDanceGymnasticsNone (doesn't affect your place on the team)

Where did you hear about us? Where did you hear about us? *Facebook EventFacebook AdInstagramGoogleWebsiteFlyerFriendOther