7th Grade Cheerleader Application
This form and $20.00 is due February 23, 2015 to the main office along with a current,
signed/cleared AHSAA physical form if one is NOT on file with the school. A student may NOT
participate in clinic without the physical form.
Student Name: ________________________________________________________
Student Phone:______________________________
Elementary School:____________________________________________________
Emergency Contact Name:_____________________________________________
Emergency Contact Phone:____________________________________________
Allergies:
We (parent and applicant) understand and agree to the requirements and
obligations of a MBJH Cheerleader.
____________________________________________________________________________________
Student Signature
__________________________________________________
Parent Signature