REGISTRATION
Registration
4267 Highway 27 South
Carlyss, LA 70665
(337)540-7714
Counter
Child's name:
Sex:
 D.O.B:
Address:
City:
Zip:
State:
Medical Conditions or
Allergies:
Parent/Guardian name:
Occupation:
Home Phone:
Cell Phone:
Other Phone:
E-Mail:
Parent/Guardian name:
Occupation:
Home Phone:
Cell Phone:
Other Phone:
E-Mail:
Class Information: CHEER OR SPORTS
How did you hear about Little Athlete's Sports Center?
Digital Signature:
Date:
Comments:
Little Athletes Sports Center, LLC
ASSUMPTION OF RISK- WAIVER OF LIABILITY -PHOTO RELEASE
- MEDICAL AUTHORIZATION
I recognize that severe injuries, including permanent paralysis or death
can occur in sports or activities involving height or motion, those
activities including but not limited to gymnastics, tumbling, martial arts,
dance, cheerleading, ball sports. Being fully aware of these dangers, I
hereby give consent for my child(ren) to participate in any and all Little
Athletes Sports Center programs and activities and I ACCEPT ALL
RISKS associated with this participation.  In consideration for my child
(ren) participation I hereby give consent for my child(ren) or our
respective heirs and successors PROMISE NOT TO SUE and
FOREVER RELEASE Little Athletes Sports Center, its officers,
directors, shareholders, employees, contractors and volunteers from
all liability resulting in damages or injuries incurred as a result of
participation including those resulting from acts of negligence.
I am aware that individual and group publicity photos and videos are
taken from time to time and in consideration for me or my child(rens)
participation I hereby grant my permission for my child’s likeness to be
used in Little Athletes Sports Center publicity or advertising.
In the event of an accident or emergency I hereby authorize my child
(ren) to be transported to a hospital for medical treatment and I hold
Little Athletes Sports Center and its representatives harmless in the
execution of such.  Additionally, I hereby agree to individually provide
for all medical expenses, which may be incurred by me, or my child
(ren) as a result of any injury sustained while participating at or for
Little Athletes Sports Center.
I have read and understand this ASSUMPTION OF RISK and WAIVER
OF LIABILITY and PHOTO RELEASE and MEDICAL
AUTHORIZATION and I VOLUNTARILY affix my name in agreement.
The number of participants that sign up for the fall classes will
determine class times
For information, call (337)540-7714.
Payment Information
Sports Registration fee: $45.00 per year (per family) Classes: $55.00
per month
Cheer Registration fee: $45.00 per year(per family) Classes $50.00
per month 1hr classes and $45.00 per month for 45min classes
(beginner classes)