2014 KSU College Prep Clinic

DATE: Sunday, November 23, 2014

TIME: Check-in 10:00am- 3:30pm
LOCATION: KSU Convocation Center- 590 Cobb Avenue Kennesaw, GA 30144

Check-in begins at 9:45am in the KSU Convocation Center.
Info meeting and tour will take place starting at 10:30am- 11:45am. A small snack will be provided at
12:00pm, the clinic will begin around 12:30pm. Please be sure to eat prior to this event, or bring lunch, it will
not be provided.
This clinic is open to guys and girls from high school freshman through current college students.
Please dress in attire that will allow you to tumble, jump, stunt, and learn band dances.
This clinic is a great opportunity for perspective athletes to get a feel for what the Kennesaw State
Cheerleading program is all about. You will gain more information on being apart of the legacy and the bright
future of the fighting owls.
This is a very informal practice so come and just be you, no need to be intimidated or nervous.

PAYMENT INFORMATION

Pre-Registration Clinic Fee is $40.00
(Cash or Checks only) Make checks payable to: Kreative Spirit Extreme, LLC- $25 Charge on all returned checksNO REFUNDS
If Pre-registering, your payment, registration form & SIGNED release forms are due (not just postmarked) by November 17
th

Pl ease send compl eted regi strati on f orm, wai ver and cl i ni c cost to:
KSU Spirit Program
Attn: 2014 College Prep Clinic
104 Victoria North Court, Woodstock GA 30189

Day of Clinic Fee is $50.00
(Cash, or money orders will be the only form of payment accepted at check-in on the day of the clinic.)
If you are registering the day of the clinic you will need your payment, registration form, & SIGNED release form at check-in.

For additional information or specific questions please contact: Head Coach AJ Boyd at
ksucheerleading@gmail.com



DIRECTIONS
Heading North on 75: Take Exit 271- Chastain Rd. Turn Left off of the Exit. Stay on Chastain Rd. and proceed to the 2nd
Traffic Light, then turn right onto Frey Rd. Make your 1st left at the next light into the east parking deck. You will see the KSU
Convocation Center on your right as you pull in to park.







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2014 KSU College Prep Clinic

Registration Form

Name:
Mai l i ng Address
Ci ty State Zi p
Gender (Check one): Mal e Femal e Bi rth date
Emai l : Cel l #
Parent(s) Name: Contact phone
Hi gh School Transf er School : GPA:
CURRENT GRADE (Ci rcl e One) 9
th
10
th
11
th
12
th
Col l ege
Al l -star-Gym Level
(Femal es Onl y) Pl ease Check Posi ti on(s) That Appl y (Max Two):
I have experi ence as an al l -gi rl FLY
I have experi ence as a COED FLY
I am a MAIN BASE (hol di ng heel toe)
I am a SIDE BASE (hol di ng mi ddl e of the f oot)
I am a BACK SPOT
Pl ease send thi s regi strati on f orm, wai ver and cl i ni c cost to:
KSU Spirit Program
Attn: 2014 College Prep Clinic
104 Victoria North Court, Woodstock GA 30189
Make checks payable to: Kreative Spirit Extreme, LLC.



KREATIVE SPIRIT EXTREME, LLC
WAIVER, RELEASE, AND PERMISSION FORM

PARTICIPANT INFORMATION (Please print)
First name: ____________________________ M.I. _____ Last name: __________________________
Date of Birth: _________________ Gender (M/F): _____
Emergency Contact/Phone number: _______________________________________________________

Event information:
KSU College Prep Clinic
Event date: Sunday, November 23, 2014
Event Host: KSU Coed Cheerleading
Sport Type: Cheer Team

PLEASE READ CAREFULLY BEFORE SIGNING
*************************************************************************************
Adult: 18 Years or Older Minor: Under 18 Years of Age at Date of Event

LIABILITY RELEASE, INDEMNITY AND PROMISE NOT TO SUE:
I, the undersigned below, in consideration of my/my childs or wards participant in the Event(s) referenced above, and any
related activities thereto (separately or collectively, the Event), wherever the Event(s) may occur, acknowledge that I am aware
that my/my childs or wards participation in the Event and the sport of dance, are prone to potential injuries including but not
limited to scrapes, bruises, twisted ankles and various injuries to the body particularly to the feet and legs, and I freely assume on
my own/my childs or wards behalf all risks incidental to such participation.
In consideration of my/my childs or wards participant in the Event and my own/my childs or wards behalf, and on behalf of
my and/or my childs or wards heirs, executors, administrators and next of kin, I hereby release, covenant not to sue, and forever
discharge the Released Parties (as defined below) of and from all liabilities, claims, actions, damages, costs and expenses of any
nature arising out of, related to, or in any way connected with my/my childs or wards participation in the Event and/or any such
related and associated activities, and further agree to indemnify and hold each of the Released Parties harmless from and against
any and all such liabilities, claims, actions, damages, costs and expenses including by way of example, but not limited to, all
attorneys fees, costs of court, and the costs and expenses of other professionals and disbursements up through and including any
appeal. I, for myself and my child and/or ward, understand that this Release and indemnify includes any claims based on the
negligence, action or inaction of any of the Released Parties and covers bodily injury (including, without limitation, death),
property damage, and loss by theft or otherwise, whether suffered by me or my child or ward either before, during or after such
participation. I declare that I/my child or ward are physically fit and have the skill level required to participate in the Event and/or
any such related and associated activities. I further authorize medical treatment for me and/or my child or ward, at my cost, if the
need arises. For the purposes hereof, the Released Parties are: Kreative Spirit Extreme, LLC; Kennesaw State University,
Kennesaw State University Athletic Association, Georgia Board of Regents, all Event sponsors and charities, and each of their
respective parent, subsidiary, affiliated or related companies; and the officers, directors, employees, agents, representatives,
successors, assigns and volunteers of each of the foregoing entities.
I also acknowledge that persons employed by Kreative Spirit Extreme, LLC may take photographs and/or videos of my
participation and allow the use of these materials without limitation or compensation including the release of my name.
This Waivers, Release, and Permission Form shall be governed by the laws of the State of Georgia, and any legal action related to
or arising out of this Waiver, Release, and Permission Form shall be commences exclusively in the Superior Court in and for
Cobb County, Georgia;
I certify I am eighteen (18) years of age or older and, if I am executing this Waiver and Permission Form on behalf of my child or
ward, the information set forth above pertaining to my child or ward is true and complete.

I HAVE READ, UNDERSTOOD AND ACCEPT THE CONDITION OF THIS (i) LIABILITY RELEASE,
INDEMNITY, AND PROMIST NOT TO SUE.
Date _________
Signature of Participant (if over 18) or
Parent (if participant is under 18) or Court Appointed Guardian
______________________________________________
Print Name of Participant (if over 18) or
Parent (if participant is under 18) or Court Appointed Guardian
______________________________________________