2016 ATHLETE INFORMATION - ADDITIONAL QUESTIONS

Name *
Name
How did you hear about QCE *
QCE Medical Release 2016 *
I / my child wishes to participate in the cheerleading program offered by Queensland Cheer Elite. I hereby acknowledge that participation in competitive cheerleading carries with it potential risks as Cheerleading, like any other sport, can be dangerous. I understand that I / my child could receive injuries such as, but not limited to, bruises, muscle strain, dislocations, broken bones and / or concussions as a results of the gymnastics, stunting, cheerleading, dance and strength training involved in QCE’s cheerleading program. I am also aware that, while very rare, participation in this program could also result in severe injuries such as permanent paralysis or even death. I am fully aware of the risks and possibility of injury involved in participating in this program and I acknowledge and understand that I / I on behalf of my son/daughter as assuming the risk of such injury in participating. I understand that due to the logistics of a cheer, dance or tumble class, it may not be possible for a QCE coach to be present or physically close enough to prevent an injury or accident from occurring in some instances. As a parent / guardian, I authorise all medical and surgical treatment, X-ray, laboratory, anesthesia and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent / guardian can be reached in the case of an emergency. I understand that I will be notified as soon as possible in the event of an emergency. I understand and agree that all expenses of such treatment are my responsibility. I hereby attest and verify that I am / my child is physically fit to participate in the strenuous exercise that is required as a part of the cheerleading program offered by QCE. I understand that if there is any reason why my child is not able to participate fully in any class or activity at QCE, we require a medical release from a doctor or medical professional (Physiotherapist or Specialist).
QCE Media Release 2016 *
I hereby give permission to Queensland Cheer Elite and its agents and employees to photograph and/or videotape me/my child. It is my understanding that the photograph/video or portions thereof will be used for public view. I agree to participate in these activities without financial remuneration, and I understand that this releases Queensland Cheer Elite from any future claims, as well as from any liability, arising from the use of the said photograph/video. I also grant to Queensland Cheer Elite the right to edit, use, and reuse said products for use in print, on the internet, and all other forms of media. I also hereby release Queensland Cheer Elite and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above.