Milwaukie High School Cheerleading Tryout Packet 2012-2013 ...

Milwaukie High
School Cheerleading
Tryout Packet
2012-2013 Season
Please do not fold or damage, you will turn this packet in
Table of Contents
* Letter to Participants
* Eligibility/ Checklist
* Schedule for Try Outs
* Questions and Answers for Try Outs
* Judges Score Sheets
* Recommendation Form
* Projected Cost for 2012-2013
* Rules and Regulations
* Parent participation form
* Cheerleader information form
* Parent/Cheerleader consent form
* Medical Forms

May 1 st , 2012
Dear Cheerleading Candidates & Parents/Guardians,
Thank you for your interest in the 2012-2013 Milwaukie High School Cheer
Team. We believe cheerleading is a rewarding and exciting sport teaching dedication,
sportsmanship, teamwork, school spirit, and hard work.
As a MHS cheerleader you will be in the forefront as a representative of the
school and will be expected to adhere to a strict code of conduct, both on and off campus.
Keeping this in mind both you and your parent or guardian will need to read the enclosed
information to ensure you fully understand both the responsibility and commitment
expected of you as a MHS cheerleader.
Milwaukie cheer is an 11 month competitive cheerleading program; please
consider the time commitment this sport will require from both the student and parents.
Your commitment will require active participation in after school practice (3x weekly
minimum), summer practice and camp, pep rallies, fundraisers, team bonding, weekly
games (football and basketball) and competitions. Due to the fact that cheerleading is a
team sport, one person’s inability to follow through on their commitment affects the
entire team.
In addition to the time commitment you will also need to consideration both your
academic requirements and the considerable financial impact. You are a student first and
an athlete second.
Please consider and evaluate all of these factors before deciding to tryout. Being a
part of this team requires commitment to yourself and the team. I look forward to an
exciting and productive year and wish each and every one of you the best of luck!
Sincerely,
Milwaukie Cheerleading Coaches
Head Coach Stephanie Yates
503-560-7009
Assistant Coach Stephanie Morrison
503-793-6384
&
Tumbling Coach Assistant Brian Morrison
For questions or Concerns reach us at
milwaukiecheerleading@gmail.com
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Eligibility And Check list
REQUIREMENTS: One chant, one Cheer, one dance and jump sequence, and stunt. The chant,
stunt, cheer and dance material will be taught at the clinic. Cheer candidates will be asked to
perform a tumbling pass at tryouts anything thing they have even if it’s a forward roll. Spotters will
not be allowed. An Interview will also be done at during tryout clinics so we can get to know you
better!
TO BE ELIGIBLE FOR TRYOUTS:
All prospective candidates must turn in the following items by Monday May 21 st by 4:15pm in order
to be considered for the try out process. If you have any questions on your eligibility or what you need
to turn in, please do not hesitate to ask.
________ A Physical Examination form current for this school year.
________ A copy of your Winter 2012 Report Card.
________ Score sheet with your name on it.
________ Teacher recommendation form: One is required, but more are encouraged.
________ Financial Commitment form signed.
________ Cheerleader information form signed.
________ Cheerleading Guidelines Acceptance form signed.
________ Parent participation form filled out.
________ Inherent Risk of Cheerleading form signed.
________ Medical Treatment Authorization form signed.
________ Medical information form filled out
________ Authorization to dispense/ Administer (OTC) Over the Counter Medicine form
________ Pay any previous student debt
________Turn in forms in 3 ring binder
Once you have all of the papers signed and filled out, place all in a ½’’ 3 ring binder with
clear overlay pocket. Write your name and the grade you’re going into and slide it in the
front cover front, feel free to decorate that paper however you want to show us your creativity.
If you do not have everything in the binder you will NOT be permitted to tryout. Binders
containing all paperwork are to be turned in no later than 4:15pm on Monday May 21 st .
The Selection process:
We will be evaluating you throughout the tryout process, based on:
1. Grades GPA
2. Conflicting activities
3. Prior behavior, performance and/or dedication to squad (returning cheerleaders)
4. Ability to follow the instruction set forth in this packet.
5. Attendance, work ethic, and attitude at try out clinics.
6. Tryout Score
7. Interview Score
Our goal is to create a successful positive cheer squad, and reserve the right to draw the line where
we see fit as to the number of cheerleaders we accept.
3

Important Dates
You must attend all try out practice clinic, and meetings unless excused by
coaches.
Tuesday May 8 th 6:30pm-7:00pm Parents are welcome to come
MHS Commons Information Meeting A Chance to ask question and learn about MHS Cheer
Monday May 21 st 4:15pm-7:00pm Brief intro meeting, warm up, Learn Motions
MHS Commons Tryout Clinic learn chants, cheer, & jumps. You will be
receiving your stunt groups and try out groups
Tuesday May 22 nd 4:15pm -7:00pm Dance!
MHS Commons Tryout Clinic
Wednesday May 23 rd 4:15pm -7:00pm Warm up, review chant, cheer, jumps,
MHS Commons Tryout Clinic and dance, work on Spirit and crowd encouragement.
Thursday May 24 th 4:15pm -9:00pm Interviews & Tryouts!!!!! After everyone tryouts
MHS Commons Tryouts judges will meet and deliberate. We will take time to
go over scores, then handout result letters.
Order of Try outs:
Cheerleader 1(flyer)- tumble on, chant
Cheerleader 2(left base)- tumble on, chant
Cheerleader 3(right base)- tumble on, chant
Cheerleader 4(back spot)- tumble on, chant
Cheerleader 5(front spot)- tumble on, chant
All do dance
All do cheer
This will repeat until all cheerleaders have gone.
Please mark calendars June 2 nd if you make the team there will be an allday
12 hour cheer event this day from 6am- 6pm with a mandatory parent
meeting from 5-6pm and a $200 deposit will be due. This is Mandatory
so please make sure you can make it!
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Milwaukie High School
Try Out Q&A’s
What should I wear to try outs
Appropriate attire should be worn to try outs each day:
You must wear white on top and black on bottom to create uniformity.
White Top: tank top, tee shirt, work out top etc
Black Bottoms: yoga pants, shorts, spandex, etc
Socks and athletic shoes
Hair pulled back from face
No jewelry (If you have a new piercing, you will not be allowed to keep it in)
No gum
No colored nail polish (clear and/or a French manicure is acceptable if they do not extend
past your finger tips)
How will I know if I made the team
After everyone has completed the tryout evaluations, the judges will calculate and total the scores
and put the teams together. Everyone will then be invited back into the commons and each student
will be handed an envelope with their determination letter.
Absolutely no one will be permitted to open their envelope until they leave the Milwaukie campus.
Failure to comply with this rule will result in removal from the squad!!!
When will camp be
We will be participating in the NCA Cheer camp, and it is tentatively scheduled for July 24 th - 27 th
2012. Camp is mandatory. If you have conflicts with this date please make the coaches aware
BEFORE you try out. If you tryout and cannot make camp, this will result in dismissal from the
squad.
When will practices be
Practices are at the discretion of your coaching staff. Please expect that conditioning will be a
minimum of 1 day per week. You will receive a schedule of commitments for the month 1 week
prior to the month starting.
What should I wear for my interview What should I expect
Treat your interview as a job interview. You must wear professional business clothing, and act in a
professional manner. You will not be given the interview questions before hand, and you will be
expected to not share the interview questions with other candidates after you complete your
interview. Failure to comply with this will result in dismissal from the try out process.
What will I be judged on
We don’t want you to encounter any surprises on what we expect from you on try out day, so we
have given you the exact form of what the judges will be using to evaluate you on try out day.
Please review it and turn it in with your other required paperwork.
What do my grades need to be
In order to try out for the 2012-2013 MHS Cheer squad you will need to have an total accumulative
grade point average of at least a 2.0. After you make the squad you can never fall below a 2.0 GPA
or you will be dismissed from the squad.
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Name______________________________________________________
Milwaukie High School Cheerleading Tryout Judging Sheet
Gymnastic Skills
Cartwheel
Round off
Back handspring
Round off/Back handspring
Anything more advanced
8 points
10 points
16 points
20 points
30 points
TOTAL_______/30
Jumps
Knowedge of four required jumps
(Toe Touch, Herkie, Side Hurdler, Front Hurdler)
Execution of jumps
(height, smooth prep, soft landing, solid landing)
Individual Chant
Sharp, precise, correct movements
Loud, audible voice projection
Synchronized with other members
Energetic and full of enthusiasm, great facials
Has correct rhythm and timing
Group Cheer
Sharp, precise, correct movements
Loud, audible voice projection
Synchronized with other members
Energetic and full of enthusiasm, great facials
Has correct rhythm and timing
_______/10
_______/10
TOTAL_______/20
________/5
________/5
________/5
________/5
________/5
TOTAL_______/ 25
________/5
________/5
________/5
________/5
________/5
TOTAL _______/25
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Group Dance
Sharp, precise, correct movements
Loud, audible voice projection
Synchronized with other members
Energetic and full of enthusiasm, great facials
Has correct rhythm and timing
________/5
________/5
________/5
________/5
________/5
TOTAL _______/25
Overall Appearance
Confident and enthusiastic
Neatly dressed; good posture; hair away from face;
no jewelry/gum/colored nail polish
Knows the sequence and precision of movements
Does not look around to others for help
Few mistakes; recovers quickly without drawing attention
________/10
________/10
________/10
________/10
________/10
TOTAL _______/50
Judge’s Total
Interview Total
_________ /175 points
_________/50 points
TOTAL SCORE___________________/225 POINTS
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Milwaukie High School Cheerleaders Recommendation Form
Instructions for applicant: 1 form is required. If you would like to submit more than 1, please photocopy this for
additional forms. Please fill in your name and grade. Then give this form to a teacher at Milwaukie High School that
will offer a recommendation on your behalf.
NAME:_________________________________________GRADE:________________
Instructions for Teacher: Please write a short assessment of the above applicant. We are particularly interested in the
applicant’s strengths, weaknesses and characteristics that would help us judge the applicant’s ability to succeed as a
productive member of Milwaukie’s cheerleading squad. Also, please give your impression of the applicant using the
chart below. Please place this form in a sealed envelope, write the candidates name on the outside and place it in the
Milwaukie Cheerleading mailbox before May 21 st 2012. This information will remain confidential.
Please give a score 1 (lowest/worst) to 10 (highest/best) based on your opinion.
1. Maturity __________
2. Dependability __________
3. Cooperation with others __________
4. Behavior in classroom __________
5. Leadership qualities __________
6. School spirit __________
7. Attitude __________
8. Ability to handle problems __________
Applicants’ current grade in your class: __________Number of absences:_________
Additional comments:_____________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Class Subject you teach: __________________________________________________
Print Name: _____________________________________ Date:__________________
Teacher Signature: ______________________________________________________
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FINANCIAL COMMITMENT FORM
Cheerleading is an expensive yet rewarding sport. The Milwaukie Cheerleading program needs
parents to volunteer and support our cheerleaders and coaches at times. Before your child is
selected, there are financial obligations that need to be addressed. This year all items will be yours
to keep once paid for.
Mandatory Item
o Uniform and Breifs $ 150.00
o Warm-ups $ 68.00
o Practice/camp/team clothing $100.00
o Hair Ribbon (2) $ 20.98
o Poms $ 15.90
o Shoes $ 39.99
o Duffel bag $ 20.00
o Face tattoos $ 6.50
o Sling Bag $ 6.31
o Shipping and Handling $ 15.00
o Camp $285.00
General Account Fees
o Pay to play, Coaches stipend, team outings, $397.36
Competition fees and food, tumbling, buses,
Coaches’ conference, and poster paint
Total- $1125 .04
(this amount can be fundraised if you put in the hard
work yourself)
Items Purchased on Own:
o White No show Socks: $ 5.00
o 5lbs Ankle weights $ 6.00
o Sports Bra $ 15.00
Fundraising opportunities will be offered immediately upon squad selection as an option to earn
money towards your individual account. Sponsorships are also encouraged. Receipts for the taxdeductible
contributions are available upon request. Sponsors name, address and donation amount
are required.
Items may be added or removed over the year such as the cost for supplies, and away game
bus/lodging. Depending on the amount of fundraising that is accomplished.
FINANCIAL COMMITMENT
I have read the information in the packet specifically regarding the financial commitment that must
be made to participate in the program. This includes both personal bills and sponsorship
expectations. I understand that all bills must be paid on time. If not child will not be able to
perform until it is paid. If my bill is still outstanding at the end of the year, my son/daughter will not
be allowed to tryout for the next season. If your account is not paid off by due date we will hold the
right of adding it to your school account. If my son/daughter is a senior, he/she will not be
permitted to participate until the bill is settled.
______________
_______________________________
Date
Parent or Guardian Signature
______________
_______________________________
Date
Students Signature
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Milwaukie Mustangs Cheerleading Tryout Application
#_______________
(Coach will Write # at Tryouts)
Cheerleader Name:__________________________________________________
Street Address:______________________________________________________
City:_____________________ Zip Code:___________
School____________________ Grade you will be in 12 -13___________________
Birth Date:______________ Home Phone Number:_______________________
Medical Conditions/Allergies:__________________________________________ Please cut photo to fit!!
Cheerleader Cell phone: ___________________________
Email:___________________________
Mom Name _____________________Cell:_________________
Email:_______________________
Place
Photo
Here
Must have to tryout!
DadName_______________________Cell:_________________EMail:______________________
Please list past cheerleading and/or gymnastics experience (identify school and/or organization
and years):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Please list the activities or sports that you will be participating in during the 2012-2013 school year
(for example,FFA, Volleyball, Dance, softball, all-star cheerleading, etc.):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
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Shirt size YL YXL AXS AS AM AL AXL
Shorts size YL YXL AXS AS AM AL AXL
Shoe size __________
Is there anything else you would like us to know and why do you want to be part of Milwaukie
Cheerleading
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
14

Milwaukie High School Cheerleading
Rules and Expectations
Please read the rules and expectations very carefully. All guidelines will be enforced.
I. Purpose
1. Encouraging the spectators to become involved.
2. Maintaining and promoting school spirit, loyalty and pride.
3. Providing service to the team, school and community through continued support of all
sports teams.
4. Encouraging and upholding of good sportsmanship on and off the field/floor.
5. Compete at a State level.
II. Conduct
1. Cheerleaders are expected to be school leaders at all times and to uphold the highest
personal standards.
2. You must act in a respectable manner at all times, remembering that you represent
Milwaukie High School.
3. Cheerleaders are to practice good sportsmanship at all times, promote sportsmanship
among all spectators and avoid emotional outbursts, whether the team wins or loses, or you
think something is unfair. Display team work and unity at all cheerleading activities.
4. Be familiar with all cheers, as well as game rules and be ready to lead cheers at
appropriate times.
5. You will not drink, eat, chew gum, comb hair or visit with friends during performances or
games. Bathroom stops should be taken before a game, at half-time, or after the game.
6. You must be able to accept constructive criticism for the improvement of the group and
yourself.
7. You must treat coaches, teachers, referees, volunteers, your peers and everyone else with
respect at ALL TIMES.
8. Cell phones must be off and put away during practice and game time.
9. Cheerleaders will reflect team effort rather than individual concerns.
10. Being healthy is a very high concern. Every cheerleader will eat healthy, and drink
plenty of water. No sweets will be allowed at practice, or at a cheer function.
III. Uniforms/Appearance
1. All parts of the uniform (basic uniform, shoes, socks, hair accessory, etc.) shall be the
same for all members of the squad.
2. All parts of the uniform are to be kept clean, pressed and repaired throughout the year.
All cleaning and repairs will be the responsibility of each member.
3. All squads shall wear full uniforms to school on game days and for pep assemblies,
unless otherwise indicated by the coach.
4. Jewelry is not part of the uniform. No jewelry is to be worn during practices or games,
due to OSAA safety guidelines. This rule includes nose rings, belly button rings, eyebrow
rings or any piercing. Plastic replacements for metal jewelry are not accepted.
5. Hair cannot be dyed a color that can’t naturally occur. (Blue, green, purple…)
6. Grooming is essential. Do not use makeup that will take away from the uniformity of the
cheerleading squad while cheering. While in uniform only clear nail polish or white tips is
allowed.
IV. Practices and Games
1. Cheerleaders may not have any unexcused practices or games. This means you must
15

communicate with your coach before the event starts as to why you cannot attend or be late.
2. Practices will be held at least 2 days per week during the season or as needed. When
preparing for competition or special events, practice may be more frequent.
3. When you arrive at a game/practice, you must be dressed, fed and ready to cheer/practice
at the assigned time or you will be considered late.
4. No member may attend a practice or game if you have been absent from school that day.
5. If you become ill during a cheer event, you may either sit with the coach or advisor or go
home as needed.
4. When practice has been deemed a mandatory practice, it is mandatory that you attend. A
cheerleader will not schedule any other activity for that time slot.
This includes all appointments (ie: church, doctor, dentist, DMV, vacations, tanning or hair
appointments) and work.
V. Double Participation
1. Any outside job, school sport, or club sport must not interfere with cheerleading practices
and performances.
2. All school activities that would prohibit participation at a practice, game or cheerleading
event must be given in written form to the coach from the school event advisor.
VI. Expenditures
1. Each cheerleader must pay a $200 participation fee at the first parent/cheerleader
meeting.
2. 100% of the uniform cost is expected to be paid or fundraised before the first football
game in fall.
3. Money will not prevent anyone from trying out. However, additional fundraising will be
done to offset your costs if you can not pay. All squad members are financially responsible
for the fees.
4. It is mandatory that you attend all fundraising events. Weeks for vacation will be
assigned at the beginning of the summer.
5. If you wish not to fundraise, you are more than welcome to do a “buy out” and pay your
cheer account.
6. It is our expectation that you should be able to fundraise your entire balance, aside from
your $200 deposit. With that, please know that it will be a huge time commitment to be able
to fundraise your remaining amount owed.
VII. Transportation
1. Cheerleaders will provide their own transportation to all events unless otherwise arranged
by the coaches/advisor/school.
2. It is school rule that the way you go to a competition is the way you leave from a
competition. If we take a bus as a team to a competition, you must ride the bus home.
VIII. Academic Requirements
1. In order to be eligible for cheerleading, a student must have a cumulative grade point
average of a 2.0. You must also be enrolled and passing at least 5 classes to be eligible.
2. Once selected a cheerleader is expected to maintain a 2.0 GPA at all times and not be
failing any classes. A copy of progress grades will be given to the coach each grading
period.
3. Unexcused absences from school must be cleared up through attendance with in three
days of the absence.
IX. Duty/Assignments
1. It is the teams’ responsibility to complete or attend the following:
A. Summer:
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i. Attend Camp
ii. Attend weekly practices
iii. Attend any fundraisers
A. Fall Season
i. Varsity Football games (all)
ii. Varsity Volleyball home games (1-2 games)
iii. Girls Varsity Soccer home games (1-2 games)
iv. Boys Varsity soccer home games (1-2 games)
v. Attend all homecoming functions
vi. Create locker signs/posters for all sports
vii. Participate in any fundraisers
B. Winter Season
i. Boys Varsity Basketball home games (all)
ii. Girls Varsity Basketball home games (all)
ii. Varsity wrestling home games (1-2 matches)
iii. Create locker signs/posters for all sports
iv. Participate in any fundraisers
3. Competitions
A. All varsity members will have the opportunity to try out for the competition
squad, and compete at an OSAA approved competition.
C. All cheerleaders not competing will be required to go to the event to support the
rest of the teams.
D. Travel to competitions will be at the coaches’ discretion.
VI. Discipline
Any school discipline policy in effect at the time that may be more restrictive will take precedence
over the cheer policy.
1. Unexcused missed practice/game/competition/fundraiser/cheer function/school: Notification
to the cheerleaders’ parents, and running 2 miles after the next practice you attend.
2. Missed game or practice: run 1 mile.
3. Consumption of sweets/soda at a cheer function: confiscation of product and
30 push ups.
3. Late for Practice or Game: 20 push ups
4. Using offensive language: 10 push ups
5. Miscellaneous Violations: Discipline varies, but cheerleader will be assigned conditioning as
punishment.
VII. Dismissal From Squad
1. All dismissals will be at the discretion and final word of the coach and school.
2. Parents will be notified when a dismissal occurs.
3. Cheerleaders will be dismissed for one or more of the following major violations:
A. Any violation as defined in the schools code of conduct, cheerleading handbook
and athletic policy.
B. Use of tobacco, alcoholic beverages, or drugs at any time.
C. Public displays of affection towards boyfriend/girlfriend on school ground.
D. More than 3 unexcused absences.
E. Uncooperative attitude within the squad or at school.
F. Disrespect shown to a coach, teacher, ref, volunteer or another team member.
G. Skipping a class or school.
H. Being suspended from school.
I. Accumulative GPA dropping below 2.0
J. Starting rumors or spreading rumors
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Coaches Availability/Expectations:
Cheerleaders and parents with concerns or questions are asked to speak privately, directly (not
through texting) and respectfully with the coaches. Parents are urged to contact coaches
concerning matters their child cannot resolve satisfactorily on their own. Your coaches want
nothing more than a positive experience for all involved. Keeping mind that our decisions are not
always popular, our focus is on what’s best for the team, program and the school. All
team/coach/parent communication will be done in person, thru phone calls, and emails try to avoid
texting when ever possible (to make sure things are not misunderstood).
Facebook policy: The Cheer program will have a Facebook page to keep cheerleaders informed
and to share team pictures. Conduct on the Facebook page is to be appropriate and positive. If this
becomes a problem it will be removed. As Coaches it is our own personal policy that we do not
“friend” our athletes or parents on our private individual pages.
SAFETY
Each year members learn the skills and techniques to not only make them successful with
performance, but also ensure they are safe when they perform those skills. Cheerleaders learn
progression in stunting, jumping, and tumbling. Coaches every year are also Safety Trained through
OSAA and maintain up-to-date First Aid & CPR cards. Despite efforts to maintain correct
progression and be as safe as possible accidents do happen. If you are concerned with the safety of
your student please contact the coaching staff!
ALL RULES & GUIDELINES ARE SUBJECT TO CHANGE AT COACH’S DISCRETION.
ALL RULES & CONSEQUENCES IN THE EXTRACURRICULAR ACTIVITIES POLICY
APPLY IN ADDITION TO THESE RULES. THOSE RULES ALSO SUPERCEDE WHEN
THEY ARE MORE RESTRICTIVE.
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2012-13 MHS Cheer Guideline Acceptance
I have read and accept the rules set forth in the 2012-13 MHS Cheer
Guidelines. I also have a copy of the Student Athletes Handbook and agree
to abide by all rules set forth.
I am satisfied with these policies.
By signing this acceptance I have taken the time to address concerns or
questions regarding the policies stated with the Coaching Staff.
Parent/Guardian
Signature: _____________________________________ Date: _______
Student Signature: _____________________________________Date: _______
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Milwaukie High School
Parent Participation Form
To be filled out by Parent/Guardian
Parent/Guardian Name _____________________________________________
Valid email address ________________________________________________
Cell Phone _______________________________________________________
Home Phone _____________________________________________________
Mailing Address___________________________________________________
Parent participation is very important in the success of the Milwaukie Cheer Team. Please
check all or some of the areas that you would be interested in helping with during the year
as a member of the Cheer Boosters.
I am interested in:
______Serving on the Cheer Boosters Board
______Helping to carpool student to events
______Helping to organize fundraisers
______Helping with communication
______Hosting cheer bonding activities
______Chaperoning cheer events (football/basketball games, competitions etc.)
______Other :____________________________________________________
____________________________________________________
_____________________________________________________
_____________________________________________________
20

INHERENT RISKS OF
CHEERLEADING
Cheerleading is a sport and with any sport there is risk of injury. Cheerleading is an
anaerobic/aerobic activity that includes jumping, stunting, motions, and tumbling. All physicals
must be on file in the school before the student can participate in the sport, practices or games.
Coaches should be informed of any injury or chronic conditions.
Although the probability of injury is minimized if you practice correctly, there is always the
possibility of one occurring. Injuries that can occur in cheerleading include but are not limited to
the following: blisters, muscle strains, ligament sprains, joint and muscle soreness, abrasions,
contusions, stress fractures, broken bones, spinal cord injuries involving paralysis and even death.
However, if you take certain precautions, the possibility of such injuries may be largely decreased.
Be sure to abide by the following:
1. Never stunt or tumble unless a coach is present.
2. Always practice in the presence of a qualified coach.
3. Always warm-up appropriately before cheering (practice and games) by jogging and
stretching.
4. Do not attempt a stunt that you do not know how to perform safely and that has not been
cleared by the coach.
5. Always use attentive spotters when stunting.
6. Always use mats or a grassy area when stunting during practice.
7. Always cheer in an area free from obstructions.
8. Do not stunt on uneven ground, wet surfaces, and concrete. Do not stunt in rainy weather.
9. Never talk, laugh, or mess around when performing a stunt or learning a stunt.
10. Report injuries to the coach as soon as they occur.
11. Follow all trainer and doctor recommendations.
12. Lift weights to increase strength and guard against injuries.
13. Always wear shoes and clothing appropriate for cheerleading.
14. Never wear jewelry of any kind or chew gum when cheering including practices and
games.
15. Always have your hair pulled back from your face and shoulders.
16. Eat nutritious meals and get plenty of rest.
17. Always ask for assistance or advice at any time.
18. Do not stunt or tumble when game is in process.
19. Never show off.
20. Take all activities seriously.
21. Do not participate in cheerleading if you are sick.
I have read the preceding warning. I thoroughly appreciate and understand the assumption of risks
inherent in cheerleading participation. I acknowledge that I am physically fit and voluntarily
participating in the activity of cheerleading.
DATE______________________________
PARENT____________________________ CHEERLEADER_____________________
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Medical Treatment Authorization and Liability/Appearance Release
I understand that there are risks of physical injury (including but not limited to cuts, sprains,
broken bones and/or catastrophic injury) associated with, arising out of, and inherent to the activitytaking
place at this event. In recognition of this acknowledged risk of injury, I knowingly and
voluntarily waive all rights and/or causes of action of any kind, including any and all claims of
negligence, arising as a result of such activity from which liability could accrue to Milwaukie High
School Cheerleading, its officers, agents, employees, instructors, subsidiaries, parent corporations
and all affiliated entities (hereinafter collectively referred to as MHSC). I hereby agree to release
MHSC and hold MHSC harmless of all liability, and hereby acknowledge that I knowingly and
voluntarily assume full responsibility for all risks of physical injury arising out of active
participation in this camp on behalf of the participant.
I am aware that this is a release of liability and acknowledgment of my voluntary and knowing
assumption of risk of injury. I have signed this document voluntarily and of my own free will in
exchange for the privilege of participation.
If I am a minor, my parent and/or legal guardian has signed this document releasing Milwaukie
High School Cheerleading from any and all such liability described above and has acknowledged
that I am knowingly and voluntarily assuming all risk of injury inherent to this activity.
The student has my permission to attend/participate in the Milwaukie Cheerleading. I warrant the
above information is complete and correct. I have completely read and understand the above
release information. I hereby authorize the Coach or their agent to act in my behalf to provide
emergency medical treatment. I further release the Milwaukie High School Cheerleading of all
liabilities associated with my child's attendance in Cheerleading.
____________________________________________ __________________
Parent/Guardian Signature
Date
____________________________________________ __________________
Students Signature
Date
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Milwaukie High School Cheerleading
MEDICAL INFORMATION FORM
Participant's Name ___________________________________
Home Address ___________________________________________
City/State/Zip _______________________________________
Home Telephone _________________________________________
Date of Birth _____________________________________
Mother's Name ___________________________________________
Day Phone ________________________________________
Father's Name _____________________________________________
Day Phone ________________________________________
If parent cannot be reached, please contact ____________________________________ Phone
_______________________________
Have you had any serious illness, surgery or injury If yes, please describe and give date(s):
________________________________________________________________________________
_____________________________________________________________
Do you have any medical problems or allergies that may interfere with Cheerleading
_____________________________________
Describe the problem or limitations
__________________________________________________________________________
Do you have medication for this, with you If yes, please describe
______________________________________________________
Insurance
Please check one:
Yes, my son/daughter has insurance and the insurance policy details are listed below:
No, my son/daughter does not have insurance (must have insurance to participate)
Insurance Company __________________________Insurance Company
Address___________________________________
Insurance Policy Number
______________________________________________________________
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Authorization to dispense/ Administer (OTC) Over The Counter
Medicine
Students Name______________________________ Date of Birth__________________
Parents/ Guardian’s Name __________________________________________________
Home number ______________________Work Number__________________________
Please List any allergies
________________________________________________________________________
Please list any long term medicines you are on, and what for. Also any of them shouldn’t be taken
with OTC medicines.
________________________________________________________________________
OTC Medicines
I, ______________________by below signature, hereby hold the cheerleading coaching staff
harmless in the administration of non-prescriptions (OTC) medications. To the above listed student.
I understand that the coaching staff will provide the medication in a single dose only. No
medication will be given for long-term use (no more then 5 consecutive days). The school and
coaching staff accept no responsibility for OTC medication that are defective, either by their design
or dosage recommendation or that are misused by the athlete. The misuse of medication by athlete
will result in athlete’s loss of medication privileges.
Parents/guardians Signature __________________________________Date___________
I Herby grant by initials permission for the coaches to administer the following OTC medications:
• Only initial ones you desire to be administered
• List below are brand names and their active ingredients (please note that actual medications
may be generic brands).
_____Tylenol(acetaminophen)
_____Benadryl (diphenhydramine HCL)
_____Midol(acetaminophen and pamabrom) _____ Advil (ibuprofen)
_____Pepto-Bismol(bismuth subsalicylate) _____Excedrin Migraine
_____Cough Drops (menthol)
(Acetaminophen, aspirin, caffeine)
This authorization shall remain in effect from the cheer season of 20_____/20_____
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