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Online Registration Form
Click here for competition details.
2015 Fall/Winter Cheer Competition and Dance Expo Registration
*
Indicates required field
Student Name
*
First
Last
Student Age
*
4
5
6
7
8
9
10
11
12
13
14
15
16+
Level
*
Beginner
Intermediate
Advanced
Gender
*
Male
Female
Instructor
*
Class Location
*
Select Location
Albemarle
Augusta
Bedford
Charlottesville
Chesapeake
Chesterfield
Cumberland
Hampton
Henrico
Powhatan
Roanoke
Suffolk
Virginia Beach
Parent Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Phone Number
*
I, the undersigned, as parents/legal guardian of the child registered on this form do hereby voluntarily submit their application for attendance and participation in the Athletes in Motion, LLC / AIM USA, INC. competition / expo and hereby assume full responsibility for any and all damages, injuries, or losses that they may sustain or incur, if any, while attending or participating, and I waive all claims against the promoters, or operators, or sponsors of Athletes in Motion, LLC / AIM USA, INC. individually or otherwise for any claim or injuries that they may sustain. I fully understand that any medical treatment given to my child will be of a first aid treatment type only. I consent that any pictures furnished by me or my child or any pictures taken of me or my child in connection with the competition / expo can be used for publicity, promotion, videos or television show, and I waive compensation in regards thereto.
Parent Electronic Signature
*
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