We welcome you to a National Award-Winning Program… BE BOLD, BE GREAT, ACCELERATE! XLR-8 Cheer Levels & Age Divisions: XLR-8 Dance Levels & Age Divisions: PRINCESSES – YOUTH PREP LEVEL 1 (Ages 4-11) TIARAS – TINY LEVEL 1 (Ages 4-6) MAJESTIES – MINI LEVEL 1 (Ages 6-8) EMPRESSES – YOUTH LEVEL 1 (Ages 8-11) QUEENS – SENIOR LEVEL 1 (Ages 10-18) CROWNS – JUNIOR LEVEL 2 (Ages 9-14) PLATINUM - PARENT TEAM (Adults Only) RED SAPPHIRES – YOUTH PREP (Ages 4-10) BLACK DIAMONDS – JUNIOR PREP (Ages 10-15) PEARLS I & II – TINY & MINI LEVEL (Ages 4-9) RUBIES I & RUBIES II – YOUTH LEVEL (Ages 8-12) JASPERS I & II – JUNIOR & SENIOR LEVEL (Ages 9-18) ONYX – SENIOR LEVEL (Ages 13-18) PLATINUM - PARENT TEAM (Adults Only) THE NUMBER … The number 8 is perhaps the most misunderstood of all single-digit numbers, as novices and professionals alike always seem to hammer on the "money and power" image of the 8. More often than not, when a client requests a name change consultation, it means he or she wants to add 8s to his or her chart in the mistaken belief that it will bring money and power. It is true that the number 8, more than any other number, puts the emphasis in the areas of career, business, finances and authority. However, as with many other single-digit numbers, the shape of the number reflects its most important attribute, and in the case of the number 8, that is, first and foremost, BALANCE. The 8 is the great Karmic equalizer, a force that just as easily creates as it destroys. When the 8 comes knocking, you can be assured that you will reap what you've sown. The 8 balances the material and immaterial worlds. At its best, it is as spiritual as it is materialistic. The spiritual side of the 8 is practical, realistic and intelligent. It knows the difference between makebelieve and genuine spiritual realizations. On the material plane, it is focused on results, often in the form of money, yet does not care much about money for the sake of money. It is not greedy, it sees money as a tool, not an end-result. It is generous and willing to take risks. People with strong 8s in their charts often make and lose fortunes a couple of times during their life. They never consider bankruptcy a reason to slow down or feel sorry, but, rather, come out stronger and more success-oriented than before. Some of the more recognizable traits of the 8 are drive, ambition, authority, efficiency, organization, management, discipline and control. The 8 is goal-oriented, focused, has good judgment, can discriminate and is practical, a realist. Its closest relative is the 1 as both numbers are powerful, have strong leadership skills, are unquestionably masculine and will not shy away from a confrontation. However, where the 1 lacks diplomatic skills and an understanding of human nature -- more typically the traits of the 2 -- the 8 has those abilities as well, which is perhaps the most important reason the 8 tends to do well in business and in authority roles (the military and law enforcement draw a lot of 8s). When the 8 appears in your personality profile chart, it indicates the presence of the character traits mentioned earlier, as well as the potential to be very successful and prosperous -- hence the reason so many people like to manipulate their charts to add one or more 8s. However, the energy of the 8 needs to be supported by other numbers in order to flourish, such as the 4 to help you keep an eye on the allimportant details, and the 9 to keep you in touch with your humanity. So be careful what you ask for. If you decide to change your name to add one or more 8s to your chart, and the rest of your chart does not support this strong force, you may come to inherit more of its negative powers like frustration, dissatisfaction, anger, aggression, greed, intolerance, hate and insomnia. A higher-than-average percentage of 8s find their way into the top echelons of society, but you will also find a disproportionate number of 8s among the homeless. If the 8 appears in your cycles, especially your Essence cycle, there is an increase in energy and focus, a sense of "can do," and enhanced self-confidence. The shape of the 8 shows balance, but it also shows confidence, as it looks you right in the eye. A positive 8 is honest to a fault, generous and forgiving. They are physically imposing and often athletic, especially good in sports requiring strength and endurance. They are not particularly romantic, as they prefer a practical and straight-forward approach, but they are loving and more than carry their weight. There are quite a few people whose charts are dominated with 8s who become priests, missionaries, humanitarians and so forth, but those sacrificing and loving souls do still tend to be good at fundraising, money management and authority. I HOPE YOU’RE READY FOR THIS XLR-8 MOVEMENT!!! XLR-8 MISSION With discipline, confidence, consciousness, and focus – WE WILL EXCEL With our training, skills, heart, and soul – WE WILL ACCELERATE Whether we sprint, jog, walk, or crawl WE MUST KEEP MOVING! The Eight (8) Principles: Accelerate social awareness (Sep) Accelerate academic achievement (Oct) Accelerate servant leadership (Nov) Accelerate community service (Dec) Accelerate spiritual consciousness (Jan) Accelerate cultural identity (Feb) Accelerate physical health (Mar) Accelerate excellence in the arts (Apr) “BE BOLD – BE GREAT – ACCELERATE” PO Box 74109 Baton Rouge, LA 70874 Dear XLR-8 Parent: As the founder of XLR-8 All-Stars, I welcome you to our national award-winning program. The coaches and staff are excited about your child's success in making one of the XLR-8 All-Star teams. We pride ourselves in being the most authentic and unique program around! We are not your everyday all-star cheerleading and dance program. We are most confident in training our youth to be great athletes; moreover, we take a special interest in facilitating the development of great students and leaders in their schools and communities. The challenging skills and techniques that your child will learn through XLR-8 are second to none. Using our eight (8) principles of acceleration, we are certain that each participant will grow as an athlete and as an individual. Throughout the year, each athlete will experience all eight of the organization’s core principles through various group initiatives and activities outside of their normal team performance events. With your help, we can continue to keep our program at the top! Trust me when I say it will not just be a full experience for the kids, but an incredible journey for the parents and family as well. I invite you to accept the challenge! If you have any questions, comments, and/or concerns about anything with relation to the program, never hesitate to contact us. You can reach us via phone or email – xlr8allstars@gmail.com. Congratulations, and I hope you are ready to be a proud XLR-8 Parent! Sincerely, Avery Wilson, CEO/President MOKA Cheerleading and Dance (225) 324-9704 Britt Dawson, Artistic Director XLR-8 All-Stars (225) 603-1858 “BE BOLD – BE GREAT – ACCELERATE” PO Box 74109 Baton Rouge, LA 70874 Congratulations and Welcome! On behalf of the XLR-8 Administrative Team, we would like to formally welcome you to the XLR-8 Family. We look forward to working with you and your family throughout the year. As the name represents, we believe in the power of acceleration and putting our children first! The XLR-8 Administrative Team will provide you with the opportunity to become more actively involved in your child’s success as an XLR-8 cheerleader/dancer. The XLR-8 Booster Club is dedicated to supporting the XLR-8 coaches, parents, and athletes in numerous ways that are intended to enrich the lives of all involved. This organization conducts fundraisers to reduce expenses for competitions, coordinates hospitality for our numerous events (providing refreshments, snacks, etc…), and organizes XLR-8 appreciation events and numerous other special initiatives and projects. Most importantly, this organization will serve as the central point of communication for everyone. We encourage all parents to actively participate in the XLR-8 Booster Club. There are several committees that you may be willing to serve for this upcoming season. The XLR-8 parents have a proud tradition of being very supportive, extremely enthusiastic, and highly visible! We have won more “Best Fan Awards” than any other program around! Additionally, our job is to effectively communicate with you with regards to your individual accounts. Should you need any assistance, please do not hesitate to contact us. Again, we would like to say, “Welcome,” and thank you in advance for your support of the XLR-8 Administrative Team & Booster Club. Sincerely yours, Sonya Murray, CFO XLR-8 All-Stars (850) 459-9522 Registration Fee: $40.00 The XLR-8 Registration fee is a one-time annual fee that each student must pay directly to XLR-8. This nonrefundable fee covers the general team affiliation for the entire year. Once a student is registered into the XLR-8 system, he/she will not be required to pay the registration cost for any other MOKA or MOKA XLR-8 Event. This fee must be paid in cash or money order on Sunday, April 26, 2015. Booster Club Fee: $20.00 The XLR-8 Booster Club fee is a one-time annual fee that each family must pay directly to XLR-8 Administrative Officers. This non-refundable fee covers the general team affiliation for the entire year. Each family receives one parent t-shirt and a year’s membership into the XLR-8 Booster Club. (Additional t-shirts are $10) This fee must be paid in cash or money order on Sunday, April 26, 2015. Team Tuition: (Competition - $100/month; Prep - $50) This non-refundable fee covers the cost of team practice, and is paid directly to XLR-8. Competition Cheer Tuition includes two practices per week for 2 hours. Tumbling class is incorporated within the team practice schedule. Prep Cheer Tuition includes one practice per week for 1.5 hours, and one monthly practice on Saturday. Practices may be added and/or canceled at the discretion of the coaching staff. THE FIRST MONTH’S TUITION IS THE ONLY TUITION THAT WILL BE COLLECTED AS A CASH/MONEY ORDER PAYMENT. MAY TUITION IS DUE – SATURDAY, MAY 9, 2015. ALL OTHER SUMMER MONTHS MUST BE PAID BY THE 8th OF THE MONTH! This fee will thereafter be paid on an automatic withdrawal system to be withdrawn on the 8th day of each month via a checking account from an approved banking institution. (All NSF Payments will be charged an additional $25.00. Parents who wish to pay tuition by cash/money order only, as opposed to automatic withdrawal, must pay for 3 months tuition at a time.) Camp & Choreography Fee: (Competition - $225; Prep - $135) This non-refundable fee is an individual cost that covers each cheerleader’s training and choreography instruction throughout the entire year. Typically, this is an all-star flat fee for one weekend of material; however, XLR-8 choreography extends beyond the competition routine and includes all exhibition and game performance routines. Option 1 – This fee must be paid in full by Sunday, June 7, 2015. Option 2 – This fee must be paid in three installments on the following dates: Competition Teams Prep Teams o Payment A (6/7/2015) - $120 o Payment A (6/7/2015) - $55 o Payment B (7/5/2015) - $105 o Payment B (7/5/2015) - $45 o Payment C (8/2/2015) - $35 Apparel & Uniforms: (Returning/New Competition - $230/$525; Prep - $290) This non-refundable fee covers the cost of apparel and accessories for the entire performance year of XLR-8. Coaches’ fees are also included in this cost, which covers all events and activities for the entire year. Option A - This fee must be paid in full by Sunday, July 5, 2015. Option B – This fee must be paid in three installments on the following dates: Returning/New Competition Teams Prep Teams o Payment A (7/5/2015) - $90/$100 o Payment A (7/5/2015) - $110 o Payment B (8/2/2015) - $80/$175 o Payment B (8/2/2015) - $100 o Payment C (9/6/2015) - $60/$150 o Payment C (9/6/2015) - $80 o Payment D (10/4/2015) – $0/$100 Registration Fee: $40.00 The XLR-8 Registration fee is a one-time annual fee that each student must pay directly to XLR-8. This nonrefundable fee covers the general team affiliation for the entire year. Once a student is registered into the XLR-8 system, he/she will not be required to pay the registration cost for any other MOKA or MOKA XLR-8 Event. This fee must be paid in cash or money order on Sunday, April 26, 2015. Booster Club Fee: $20.00 The XLR-8 Booster Club fee is a one-time annual fee that each family must pay directly to XLR-8 Administrative Officers. This non-refundable fee covers the general team affiliation for the entire year. Each family receives one parent t-shirt and a year’s membership into the XLR-8 Booster Club. (Additional t-shirts are $10) This fee must be paid in cash or money order on Sunday, April 26, 2015. Team Tuition: (Females - $100/month; Prep - $50/month) This non-refundable fee covers the cost of team practice, and is paid directly to XLR-8. Competition Dance Tuition includes two practices per week for 2 hours and one additional technique class per month. Prep Dance Tuition includes one practice per week for 1.5 hours, one monthly practice on Saturday, and one additional technique class per month. Practices may be added and/or canceled at the discretion of the coaching staff. THE FIRST MONTH’S TUITION IS THE ONLY TUITION THAT WILL BE COLLECTED AS A CASH/MONEY ORDER PAYMENT. MAY TUITION IS DUE – SUNDAY, MAY 10, 2015. ALL OTHER SUMMER MONTHS MUST BE PAID BY THE 8th OF THE MONTH! This fee will thereafter be paid on an automatic withdrawal system to be withdrawn on the 8th day of each month via a checking account from an approved banking institution. (All NSF Payments will be charged an additional $25.00. Parents who wish to pay tuition by cash/money order only, as opposed to automatic withdrawal, must pay for 3 months tuition at a time Camp & Choreography Fee: (Competition - $245; Prep - $135) This non-refundable fee is an individual cost that covers each dancer’s training and choreography instruction throughout the entire year. Typically, this is an all-star flat fee for one weekend of material; however, XLR-8 choreography extends beyond the competition routine and includes all exhibition and game performance routines. Option 1 – This fee must be paid in full by Sunday, June 7, 2015. Option 2 – This fee must be paid in three installments on the following dates: Competition Teams Prep Teams o Payment A (6/7/2015) - $140 o Payment A (6/7/2015) - $55 o Payment B (7/5/2015) - $105 o Payment B (7/5/2015) - $45 o Payment C (8/2/2015) - $35 Apparel & Uniforms: (Returning/New Competition - $360/$580; Prep - $320) This non-refundable fee covers the cost of apparel and accessories for the entire performance year of XLR-8. Coaches’ fees are also included in this cost, which covers all events and activities for the entire year. Option A - This fee must be paid in full by Sunday, July 5, 2015. Option B – This fee must be paid in three installments on the following dates: Returning/New Competition Teams Prep Teams o Payment A (7/5/2015) - $135/$145 o Payment A (7/5/2015) - $125 o Payment B (8/2/2015) - $125/$185 o Payment B (8/2/2015) - $110 o Payment C (9/6/2015) - $100/$175 o Payment C (9/6/2015) - $85 o Payment D (10/4/2015) – $0/$75 Apparel & Uniform Information Participant’s Name _______________________________________ Team Placement _______________________________________ Mark If Needed Size RETURNING ITEMS Competition Uniform Top $135.00 __________ Competition Uniform Short $70.00 __________ Warm-up Jacket $40.00 __________ Warm-up Pants $30.00 __________ Team Make-up $20.00 NEW ITEMS Coaches’ Fee $60.00 Team Tote Bag $20.00 Program Simple Tee #1 $10.00 __________ Practice Top $35.00 __________ Practice Bottoms $20.00 __________ Sneakers $60.00 __________ Hair Accesories $25.00 NEW COMPETITION COST $525.00 RETURNING COMPETITION $230.00 Apparel & Uniform Information Participant’s Name _______________________________________ Team Placement _______________________________________ Size Mark If Needed RETURNING ITEMS N/A NEW ITEMS Coaches’ Fee $30.00 Performance Uniform $135.00 Team Make-up $20.00 Team Tote Bag $20.00 Program Simple Tee #1 $10.00 __________ Sneakers $60.00 __________ Hair Accesories $15.00 __________ NEW PREP COST $290.00 RETURNING PREP COST N/A Apparel & Uniform Information Participant’s Name _______________________________________ Team Placement _______________________________________ Mark If Needed Size RETURNING ITEMS Program Uniform Top $75.00 __________ Program Uniform Hot Shorts $25.00 __________ Program Uniform Jazz Pants $30.00 __________ Program Warm-up Jacket $40.00 __________ Program Warm-up Pant $30.00 __________ Team Make-up $20.00 NEW ITEMS Coaches’ Fee $60.00 Team Tan Jazz Shoes $30.00 __________ Competition Uniforms $100.00 __________ Team Tights $10.00 __________ Team Tote Bag $20.00 Program Simple Tee #1 $10.00 __________ Program Practice Top $25.00 __________ Program Practice Bottoms $40.00 __________ Program Black Sneakers $50.00 __________ Miscellaneous Needs/Props $15.00 NEW COMPETITION COST $580.00 RETURNING COMPETITION COST $360.00 *This list is NOT inclusive of things that the staff considers basic dance needs such as black mid-calf tights, black tank leotard, black slip-on jazz shoes, etc… Apparel & Uniform Information Participant’s Name _______________________________________ Team Placement _______________________________________ Mark If Needed Size RETURNING ITEMS N/A NEW ITEMS Coaches’ Fee $30.00 Team Tan Jazz Shoes $30.00 __________ Performance Uniforms $150.00 __________ Team Tights $10.00 __________ Team Tote Bag $20.00 Team Make-up $20.00 Program Simple Tee #1 $10.00 __________ Program Black Sneakers $50.00 __________ NEW PREP COST $320.00 RETURNING PREP COST N/A *This list is NOT inclusive of things that the staff considers basic dance needs such as black mid-calf tights, black tank leotard, black slip-on jazz shoes, etc… Competition & Event Information 2015-2016 All teams compete in several regional and national competitions. Team members are expected to compete at all competitions scheduled. Parents must make all travel and lodging arrangements for each competition. Although the competition schedule is set, it is the discretion of the staff to change any competitive appearance decision for what would be considered a major administrative/executive/artistic reason. COMPETITION / EVENT Summer Fest EVENT DATE(S) “BE BOLD – BE GREAT – XLR-8!” August 29, 2015 Baton Rouge, Louisiana Summer Production Showcase Theme TBD August 30, 2015 Baton Rouge, Louisiana PAYMENT DUE DATE COMPETITION/EVENT PAYMENT A DUE AUGUST 2, 2015 $70.00 Competition #1 WSA Hometown Throw Down Regionals November 21, 2015 Baton Rouge, Louisiana Competition #2 MOKA Cheer & Dance Regionals December 12, 2015 Baton Rouge, Louisiana XLR-8 Christmas Jam Tis da Season to Cheer & Dance COMPETITION/EVENT PAYMENT B DUE SEPTEMBER 6, 2015 $100.00 December 18 or 19, 2015 Baton Rouge, Louisiana Competition #3 WSA Regionals January 16, 2016 Dallas, Texas Competition #4 WSA Regionals January 31, 2016 Mobile, Alabama COMPETITION/EVENT PAYMENT C DUE OCTOBER 4, 2015 $175.00 MOKA XLR-8 ON THE BLUFF Southern University Game Performance February 2016 Baton Rouge, Louisiana Competition #5 WSA Regionals March 5, 2016 Jackson, Mississippi Competition #6 Grand Nationals COMPETITION/EVENT PAYMENT D DUE NOVEMBER 1, 2015 $125.00 March 19-20, 2016 New Orleans, Louisiana Competition #7 Black College Nationals April 9, 2016 Fayetteville, North Carolina Spring Production “It’s An XLR-8tion” Baton Rouge, Louisiana May 1, 2016 COMPETITION/EVENT PAYMENT E DUE DECEMBER 6, 2015 $130.00 Competition & Event Information 2015-2016 All teams compete in several regional and national competitions. Team members are expected to compete at all competitions scheduled. Parents must make all travel and lodging arrangements for each competition. Although the competition schedule is set, it is the discretion of the staff to change any competitive appearance decision for what would be considered a major administrative/executive/artistic reason. COMPETITION / EVENT Summer Fest EVENT DATE(S) “BE BOLD – BE GREAT – XLR-8!” August 29, 2015 Baton Rouge, Louisiana Summer Production Showcase Theme TBD August 30, 2015 Baton Rouge, Louisiana PAYMENT DUE DATE COMPETITION/EVENT PAYMENT A DUE AUGUST 2, 2015 $70.00 Competition #1 WSA Hometown Throw Down Regionals November 21, 2015 Baton Rouge, Louisiana Competition #2 MOKA Cheer & Dance Regionals December 12, 2015 Baton Rouge, Louisiana XLR-8 Christmas Jam Tis da Season to Cheer & Dance COMPETITION/EVENT PAYMENT B DUE SEPTEMBER 6, 2015 $100.00 December 18 or 19, 2015 Baton Rouge, Louisiana Competition #3 WSA Regionals January 16, 2016 Dallas, Texas MOKA XLR-8 ON THE BLUFF Southern University Game Performance February 2016 Baton Rouge, Louisiana COMPETITION/EVENT PAYMENT C DUE OCTOBER 4, 2015 $175.00 Competition #4 WSA Regionals March 5, 2016 Jackson, Mississippi Competition #5 Starpower Dance Competition March 12, 2016 Baton Rouge, Louisiana Competition #6 Grand Nationals COMPETITION/EVENT PAYMENT D DUE NOVEMBER 1, 2015 $125.00 March 19-20, 2016 New Orleans, Louisiana Competition #7 Black College Nationals April 9, 2016 Fayetteville, North Carolina Spring Production “It’s An XLR-8tion” Baton Rouge, Louisiana May 1, 2016 COMPETITION/EVENT PAYMENT E DUE DECEMBER 6, 2015 $130.00 Competition & Event Information 2015-2016 All teams compete in several regional and national competitions. Team members are expected to compete at all competitions scheduled. Parents must make all travel and lodging arrangements for each competition. Although the competition schedule is set, it is the discretion of the staff to change any competitive appearance decision for what would be considered a major administrative/executive/artistic reason. COMPETITION / EVENT Summer Fest EVENT DATE(S) “BE BOLD – BE GREAT – XLR-8!” August 29, 2015 Baton Rouge, Louisiana Summer Production Showcase Theme TBD August 30, 2015 Baton Rouge, Louisiana Parade #1 Southern University Homecoming PAYMENT DUE DATE COMPETITION/EVENT PAYMENT A DUE SEPTEMBER 6, 2015 $80.00 October 17, 2015 Baton Rouge, Louisiana Exhibition Performance #1 MOKA Cheer & Dance Regionals December 12, 2015 Baton Rouge, Louisiana XLR-8 Christmas Jam Tis da Season to Cheer & Dance December 18 or 19, 2015 Baton Rouge, Louisiana Parade #2 Mardi Gras COMPETITION/EVENT PAYMENT B DUE OCTOBER 4, 2015 $60.00 February 6-8, 2016 Baton Rouge, Louisiana Parade #3 Mardi Gras February 6-8, 2016 New Orleans, Louisiana MOKA XLR-8 ON THE BLUFF Southern University Game Performance February 2016 Baton Rouge, Louisiana Exhibition Performance #2 WSA Regionals COMPETITION/EVENT PAYMENT C DUE NOVEMBER 1, 2015 $40.00 March 5, 2016 Jackson, Mississippi Exhibition Performance #3 BR Fest For All March 2016 Baton Rouge, Louisiana Exhibition Performance #4 New Orleans Pelicans Game Performance April 2016 New Orleans, Louisiana Spring Production “It’s An XLR-8tion” Baton Rouge, Louisiana COMPETITION/EVENT PAYMENT C DUE DECEMBER 6, 2015 $20.00 May 1, 2016 Who do I pay? Tuition payments and all team fees will be made via cash, money order, or debit/credit card. ALL XLR-8 PAYMENTS MUST BE MADE TO THE ADMINISTRATIVE OFFICERS. Money orders should be made payable to MOKA XLR-8. Remember, after the first month’s tuition payment, all tuition is withdrawn automatically from a checking account of your choice on the 8th of every month. If under any circumstance the administrative officers are not present at a team meeting, practice, or booster meeting, payments should be held until the next available opportunity. Payments should be made at the BEGINNING OF PRACTICE/MEETING! Please do not expect the officers to wait after a practice is over to collect your payment. Administrative Officers will not be responsible for any payments made to anyone else. What should I write on the money order? Please help the Administrative Officers by writing your child’s FULL NAME at the bottom of each money order! It is also important that you briefly describe as best as possible what your payment is for! Copies of money orders are kept on file for discrepancies; however, it will be greatly appreciated if you help out with this matter! (Nicknames are not acceptable!) Cash payments will be issued a receipt at the same time of payment. It is each parent’s responsibility to request a receipt for any and all payments. Late Payments Any payment made after the due date is considered late. All late payments will incur a $10.00 charge! This fee is automatically added to your XLR-8 account after the payment date has passed. (All fee deadlines are always communicated on team schedules, emails, or handouts. No special arrangements are made for intentional late payments. Please be prepared to add the late charge on all tardy fees. How Unpaid Fees Affect the Athletes… Coaches reserve the right to put students on non-performance restrictions and non-practice restrictions for unpaid fees. This information is communicated through the administrative officers and can be a spontaneous decision. Participants will still be expected to be present at the practice and/or event. The cheerleader/dancer will be instructed to be seated on the side in a non-participatory manner. Season Payment Schedule Payment Date Sunday, April 26, 2015 Saturday, May 9, 2015 Sunday, June 7, 2015 Sunday, July 5, 2015 Sunday, August 2, 2015 Payment Description Payment Amount XLR-8 Registration Fee & Booster $60 Total Due $60 XLR-8 Tuition $100 Total Due $100 XLR-8 Tuition $100 Camp & Choreography Payment A $120 Total Due $220 XLR-8 Tuition $100 Camp & Choreography Payment B $105 Uniform Payment A $90 Total Due $295 XLR-8 Tuition Uniform Payment B Competition & Event Fee A $100 $80 $70 Total Due Sunday, September 6, 2015 XLR-8 Tuition Uniform Payment C Competition & Event Fee B $250 $100 $60 $100 Total Due Sunday, October 4, 2015 XLR-8 Tuition Competition & Event Fee C $260 $100 $175 Total Due Sunday, November 1, 2015 XLR-8 Tuition Competition & Event Fee D $275 $100 $125 Total Due Sunday, December 6, 2015 XLR-8 Tuition Competition & Event Fee E $225 $100 $130 Total Due Sunday, January 3, 2016 Sunday, February 7, 2016 Sunday, March 7, 2016 Sunday, April 4, 2016 XLR-8 Tuition $230 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due $100 Paid Season Payment Schedule Payment Date Sunday, April 26, 2015 Saturday, May 9, 2015 Sunday, June 7, 2015 Sunday, July 5, 2015 Sunday, August 2, 2015 Payment Description Payment Amount XLR-8 Registration Fee & Booster $60 Total Due $60 XLR-8 Tuition $100 Total Due $100 XLR-8 Tuition $100 Camp & Choreography Payment A $120 Total Due $220 XLR-8 Tuition $100 Camp & Choreography Payment B $105 Uniform Payment A $100 Total Due $305 XLR-8 Tuition Uniform Payment B Competition & Event Fee A $100 $175 $70 Total Due Sunday, September 6, 2015 XLR-8 Tuition Uniform Payment C Competition & Event Fee B $345 $100 $150 $100 Total Due Sunday, October 4, 2015 XLR-8 Tuition Uniform Payment D Competition & Event Fee C $350 $100 $100 $175 Total Due Sunday, November 1, 2015 XLR-8 Tuition Competition & Event Fee D $375 $100 $125 Total Due Sunday, December 6, 2015 XLR-8 Tuition Competition & Event Fee E $225 $100 $130 Total Due Sunday, January 3, 2016 Sunday, February 7, 2016 Sunday, March 7, 2016 Sunday, April 4, 2016 XLR-8 Tuition $230 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due $100 Paid Season Payment Schedule Payment Date Sunday, April 26, 2015 Saturday, May 9, 2015 Sunday, June 7, 2015 Sunday, July 5, 2015 Sunday, August 2, 2015 Sunday, September 6, 2015 Payment Description Payment Amount XLR-8 Registration Fee & Booster $60 Total Due $60 XLR-8 Tuition $50 Total Due $50 XLR-8 Tuition $50 Camp & Choreography Payment A $55 Total Due $105 XLR-8 Tuition $50 Camp & Choreography Payment B $45 Uniform Payment A $110 Total Due $205 XLR-8 Tuition $50 Camp & Choreography Payment C $35 Uniform Payment B $100 Total Due $185 XLR-8 Tuition Uniform Payment C Competition & Event Fee A $50 $80 $80 Total Due Sunday, October 4, 2015 XLR-8 Tuition Competition & Event Fee B $210 $50 $60 Total Due Sunday, November 1, 2015 XLR-8 Tuition Competition & Event Fee C $110 $50 $40 Total Due Sunday, December 6, 2015 XLR-8 Tuition Competition & Event Fee D $90 $50 $20 Total Due Sunday, January 3, 2016 Sunday, February 7, 2016 Sunday, March 7, 2016 Sunday, April 4, 2016 XLR-8 Tuition $70 $50 Total Due XLR-8 Tuition $50 $50 Total Due XLR-8 Tuition $50 $50 Total Due XLR-8 Tuition $50 $50 Total Due $50 Paid Season Payment Schedule Payment Date Sunday, April 26, 2015 Saturday, May 9, 2015 Sunday, June 7, 2015 Sunday, July 5, 2015 Sunday, August 2, 2015 Payment Description Payment Amount XLR-8 Registration Fee & Booster $60 Total Due $60 XLR-8 Tuition $100 Total Due $100 XLR-8 Tuition $100 Camp & Choreography Payment A $140 Total Due $240 XLR-8 Tuition $100 Camp & Choreography Payment B $105 Uniform Payment A $135 Total Due $340 XLR-8 Tuition Uniform Payment B Competition & Event Fee A $100 $125 $70 Total Due Sunday, September 6, 2015 XLR-8 Tuition Uniform Payment C Competition & Event Fee B $295 $100 $100 $100 Total Due Sunday, October 4, 2015 XLR-8 Tuition Competition & Event Fee C $300 $100 $175 Total Due Sunday, November 1, 2015 XLR-8 Tuition Competition & Event Fee D $275 $100 $125 Total Due Sunday, December 6, 2015 XLR-8 Tuition Competition & Event Fee E $225 $100 $130 Total Due Sunday, January 3, 2016 Sunday, February 7, 2016 Sunday, March 7, 2016 Sunday, April 4, 2016 XLR-8 Tuition $230 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due $100 Paid Season Payment Schedule Payment Date Sunday, April 26, 2015 Saturday, May 9, 2015 Sunday, June 7, 2015 Sunday, July 5, 2015 Sunday, August 2, 2015 Payment Description Payment Amount XLR-8 Registration Fee & Booster $60 Total Due $60 XLR-8 Tuition $100 Total Due $100 XLR-8 Tuition $100 Camp & Choreography Payment A $140 Total Due $240 XLR-8 Tuition $100 Camp & Choreography Payment B $105 Uniform Payment A $145 Total Due $350 XLR-8 Tuition Uniform Payment B Competition & Event Fee A $100 $185 $70 Total Due Sunday, September 6, 2015 XLR-8 Tuition Uniform Payment C Competition & Event Fee B $355 $100 $175 $100 Total Due Sunday, October 4, 2015 XLR-8 Tuition Uniform Payment D Competition & Event Fee C $375 $100 $75 $175 Total Due Sunday, November 1, 2015 XLR-8 Tuition Competition & Event Fee D $350 $100 $125 Total Due Sunday, December 6, 2015 XLR-8 Tuition Competition & Event Fee E $225 $100 $130 Total Due Sunday, January 3, 2016 Sunday, February 7, 2016 Sunday, March 7, 2016 Sunday, April 4, 2016 XLR-8 Tuition $230 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due XLR-8 Tuition $100 $100 Total Due $100 Paid Season Payment Schedule Payment Date Sunday, April 26, 2015 Saturday, May 9, 2015 Sunday, June 7, 2015 Sunday, July 5, 2015 Sunday, August 2, 2015 Sunday, September 6, 2015 Payment Description Payment Amount XLR-8 Registration Fee & Booster $60 Total Due $60 XLR-8 Tuition $50 Total Due $50 XLR-8 Tuition $50 Camp & Choreography Payment A $55 Total Due $105 XLR-8 Tuition $50 Camp & Choreography Payment B $45 Uniform Payment A $125 Total Due $220 XLR-8 Tuition $50 Camp & Choreography Payment C $35 Uniform Payment B $110 Total Due $195 XLR-8 Tuition Uniform Payment C Competition & Event Fee A $50 $85 $80 Total Due Sunday, October 4, 2015 XLR-8 Tuition Competition & Event Fee B $215 $50 $60 Total Due Sunday, November 1, 2015 XLR-8 Tuition Competition & Event Fee C $110 $50 $40 Total Due Sunday, December 6, 2015 XLR-8 Tuition Competition & Event Fee D $90 $50 $20 Total Due Sunday, January 3, 2016 Sunday, February 7, 2016 Sunday, March 7, 2016 Sunday, April 4, 2016 XLR-8 Tuition $70 $50 Total Due XLR-8 Tuition $50 $50 Total Due XLR-8 Tuition $50 $50 Total Due XLR-8 Tuition $50 $50 Total Due $50 Paid Can I pay everything at once? YES! While this payment process is an all-inclusive payment, it does NOT have to be paid at once. As long as the installments are completed by the deadline for this offer, participants are still eligible to redeem the bundle package discount! ALL COMPETITION PARTICIPANTS who choose this option will save - $350.00! ALL RECREATION PARTICIPANTS who choose this option will save - $150.00! This non-refundable payment includes two parts: Part One Registration and Booster Payment Due: April 26, 2015 Part Two Full Year Payment (10 Months Tuition, Choreography Fee, Competition Fees, & Uniform Fees) Due: July 5, 2015 Can I pay ON everything at once and still receive the bundle package? NO! This incentive is only valid for participants who are paying for the entire year IN FULL. Unfortunately, no partial payments or installments are deemed valid that go beyond the deadline date. Skill-Performance Enhancers XLR-8 Staff Privates Cheerleaders and dancers can schedule a private with any XLR-8 Coach / Staff Instructor to work on any skills of choice. (Motion technique, jumps, stunts, tumbling, general conditioning, leaps, turns, kicks, choreography, etc...) ALL cheer and dance privates are paid directly to the instructor of choice in cash. While private sessions are not mandatory, cheerleaders and dancers are highly encouraged to have at least one private every two months to sharpen his/her skills. ** Individual choreography is oftentimes a separate fee pending the nature of the request. Cheerleaders and dancers who are interested in competing in solo divisions or small group divisions must factor in additional fees for choreographic needs. Be sure to understand all parts of the agreement between you and the instructor of choice for individual choreography. Technique Class All competition dance team members must attend at least two technique classes per month during the summer months. The technique classes are skill-based and open to the community as well. There is also a master-class offered periodically on Friday evenings that entails various skill ranges and dance genres. Master Class can substitute any technique class for competition monthly requirements. ALL CHEERLEADERS ONE FREE DANCE TECHNIQUE CLASS PER MONTH. ALL DANCERS RECEIVE TWO FREE DANCE TECHNIQUE CLASSES PER MONTH! TEAM PRACTICE SCHEDULE 2015-2016 MONDAY TUESDAY WEDNESDAY Studio Gym Studio Gym Studio Gym 4:00pm – 4:55pm Not Available Not Available Not Available Not Available Not Available Not Available 5:00pm – 5:55pm Private/ Group Prep Cheer Youth Princesses 5:45-6:45pm Not Available Not Available Private/ Group Private/ Group 6:00pm – 6:55pm XLR-8 Dance Rubies 6:00-8:00pm XLR-8 Cheer Tiny Tiaras 6:00-8:00pm Prep Dance Red Sapphires 6:30-8:00pm Not Available XLR-8 Dance Pearls 6:00-8:00pm XLR-8 Cheer Mini Majesties 6:00-8:00pm XLR-8 Dance Onyx 7:00-9:00pm XLR-8 Cheer Youth Empresses 7:00-9:00pm Prep Dance Black Diamonds 7:30-9:00pm XLR-8 Cheer Senior Queens 7:00-9:00pm XLR-8 Dance Jaspers 7:00-9:00pm XLR-8 Cheer Junior Crowns 7:00-9:00pm 7:00pm – 7:55pm 8:00pm – 8:55pm SATURDAY Prep Cheer Youth Princesses 9am-11am Prep Dance Red Sapphires & Black Diamonds 9am-11am Prep Teams Practice on 2nd Saturdays Only 11:00am – 11:55am Beginner Level I Technique Class 12:00pm – 12:55pm Intermediate Level II Technique Class 1:00pm – 1:55pm Advanced Level III Technique Class SUNDAY CHEER XLR-8 Tiny Tiaras 2:00-4:00pm SUNDAY DANCE XLR-8 Cheer & Dance Parent Platinum Team Dates & Times TBD Private/ Group XLR-8 Mini Majesties 3:15-5:15pm XLR-8 Youth Empresses 4:30-6:30pm XLR-8 Pearls 2:30-4:30pm XLR-8 Jaspers 4:00-6:00pm XLR-8 Junior Crowns 5:45-7:45pm XLR-8 Senior Queens 7:00-9:00pm XLR-8 Rubies 5:30-7:30pm XLR-8 Onyx 7:00-9:00pm Class Card Packages NO TECHNIQUE CLASS REGISTRATION FEE! 1 Card - $12.00 8 Cards - $50 Technique Classes operate by Class Cards ONLY. 2 Cards - $20.00 12 Cards - $70 Class participation is not permissible without a card. 4 Cards - $30.00 16 Cards - $90 Cash/Debit/Money Order Only (All Payments Made Payable to XLR-8) Class maximums for participation operate on a first-come, first-served basis. EXECUTIVE & ADMINISTRATIVE TEAM Chief Executive Officer Chief Financial Officer Avery D. Wilson (225) 324-9704 Sonya Murray (850) 459-9522 Program Artistic Director Britt Dawson (225) 603-1858 Prep Dance Coordinator Shira J. Brown (225) 270-4123 All-Star Lead Dance Instructor Ebony Yarbrough (225) 328-3165 Prep Cheer Coordinator Mo Brady (225) 615-0854 All-Star Lead Cheer Instructor Mo Brady (225) 615-0854 FINANCE & CORRESPONDENCE ADMINISTRATORS Correspondence Committee (2) This committee is responsible for all internal parental communication beyond the efforts of the coaching and chief administrator. These parents use the team phone directory to make the necessary phone calls and/or emails to all XLR-8 parents to disseminate important team information with regards to the team schedule, practices, and all performances. The correspondence committee members also extend birthday wishes to all cheerleaders and dancers, and also contact XLR-8 families in times of grievance or family need. Fundraising and Corporate Sponsorship (2) This committee shall solicit small and large corporate sponsors for the general budget of the XLR-8 Booster Club. These funds help support XLR-8 special events and the overall company for operational purposes. The committee shall also solicit financial or itemed donations from community businesses or individuals that support XLR-8 events. Additionally, this committee shall create and manage all program fundraisers that will be created for individual account aid and overall program support. SERVICE & PROGRAMMING ADMINISTRATORS Paraphernalia Committee (2) This committee shall be responsible for the purchase, sale, and distribution of team noisemakers, accessories, posters, banners, t-shirts, and trinkets for all performance-events and competitions. Committee members shall also coordinate the development of any additional initiatives that coincide with performances. The 8 Principles Initiatives Committee (2) This committee is responsible for the formulation of the program projects that are related to each monthly principle. Committee members will create one (1) project per month throughout the last eight months of the season; and create the logistics of operation for each project chosen. Team Handbook 2015-2016 XLR-8 MISSION With discipline, confidence, consciousness, and focus – WE WILL EXCEL With our training, skills, heart, and soul – WE WILL ACCELERATE Whether we sprint, jog, walk, or crawl WE MUST KEEP MOVING! 2015-2016 XLR-8 Program Rules & Policies XLR-8 Agreement: Every XLR-8 family is expected to be committed to the XLR-8 All-Star program for a full season. This commitment requires full participation in exhibition, community service, gym training, and competitive events for each XLR-8 squad member for the entire season. Squad Placement: Every child is evaluated and grouped by technical ability and overall potential. Squad placement is determined by his/her evaluation score, strength & flexibility, age & grade, leadership ability, and where he/she can best be utilized. Squad levels may change throughout the year depending on the skill level of that squad. Additionally, participants may be asked to crossover and compete on more than one squad pending the aforementioned criteria. XLR-8 Cheer Levels & Age Divisions: XLR-8 Dance Levels & Age Divisions: PRINCESSES – YOUTH PREP LEVEL 1 (Ages 4-11) TIARAS – TINY LEVEL 1 (Ages 4-6) MAJESTIES – MINI LEVEL 1 (Ages 6-8) EMPRESSES – YOUTH LEVEL 1 (Ages 8-11) QUEENS – SENIOR LEVEL 1 (Ages 10-18) CROWNS – JUNIOR LEVEL 2 (Ages 9-14) PLATINUM - PARENT TEAM (Adults Only) RED SAPPHIRES – YOUTH PREP (Ages 4-10) BLACK DIAMONDS – JUNIOR PREP (Ages 10-15) PEARLS I & II – TINY & MINI LEVEL (Ages 4-9) RUBIES I & RUBIES II – YOUTH LEVEL (Ages 8-12) JASPERS I & II – JUNIOR & SENIOR LEVEL (Ages 9-18) ONYX – SENIOR LEVEL (Ages 13-18) PLATINUM - PARENT TEAM (Adults Only) Training Days & Times: All team training is pre-determined. Parents will receive the practice schedule before the season begins. All performance and event schedules are tentative! If any changes should arise, you will be notified ASAP. All teams practice twice per week, except the prep teams who practice once per week with one additional practice on the second Saturday of each month. All competition dance teams are REQUIRED to take Technique Class atleast twice per month during the summer months. Level placements will be announced on June 14, 2015. Camps & Choreography: All team choreography is done in-house. All participants must pay a one-time choreography fee for all competitive and exhibition team routines; which are taught throughout the entire season. All summer camps are mandatory for all cheerleaders and dancers. The Summer Dance Intensive is mandatory for all dancers. NO EXCEPTIONS! Attendance: Attending regularly scheduled practice is a MUST for every cheerleader/dancer. These are TEAM sports…unlike any other! When ONE person is out, it affects the ENTIRE squad! Missing practice during the week of a competition for a traditionally “excused-purpose” is NOT allowed. Failure to make all scheduled practices during competition week may lead to suspension and/or dismissal from an XLR-8 squad, with fees still due. In the event that any athlete should need to miss a competition, you will need to turn in “WRITTEN NOTICE” of this to the XLR-8 Chief Administrator, Sonya Murray, no later than 21 days before that competition. Any athlete missing a competition without a 21-day notice may lead to suspension and/or dismissal from an XLR-8 squad, with fees still due. Written notices are still considered an excused absence in this case. Team practice absences and event absences are counted separately. All policy infractions are tallied in 1-month intervals. It is imperative that parents are respectful of pick-up time after practice. Parents who intentionally abuse our care-taking policy by being more than 15 minutes late for pick-up will force an additional absence added to the student’s monthly count; and will be grounds for dismissal upon repeat offenses. It is mandatory, ALL XLR-8 TEAMS MUST ATTEND THE ENTIRE COMPETITION FOR EACH XLR-8 TEAM: This shows great support to your other squad members and represents the XLR-8 Program best. This rule must always be adhered to unless special instructions are given for a specific competition. XLR-8 Attendance Chart: Excused Absences Unexcused Absences Tardy Rule (include but are not limited to) (include but are not limited to) (more than 8 minutes late) *Major family events, major school activities, major church activities: ONLY if these dates are turned in at the beginning of the month. (Director determines what is considered major) *Family emergencies: sickness/death *Doctor’s-documented contagious illness or serious injury *Non-contagious illness or minor injury (being at practice just to watch is a must for such instances) *Participation in other sports or community activities *Special events/Minor family events *Poor grades or Homework – Please plan accordingly… *School activities – those dates that are not turned in to coaches in at the beginning of the month… Please plan accordingly. *It doesn’t matter how late a practice has ended! Parents are encouraged not to take students from coaches without performing their duties unless approved. *All athletes must call one of his/her coaches to inform them of tardiness beyond 10 minutes. *All policy infractions are per month * XLR-8 Practice Attendance Consequence Chart: Excused Unexcused *1 excused absence = NO PENALTY *2 excused absences = NO PENALTY *2 unexcused absences = S-C Meeting *3 excused absences = NO PENALTY *3 unexcused absences = S-C Meeting *4 excused absences = S-C Meeting *4 unexcused absences = *5 excused absences = S-C Meeting Tardy *1 unexcused absence = NO PENALTY Tardiness is heavily discouraged! Coaches will conduct a student-coach meeting for extreme tardiness or repeat cases. Consideration for TEAM DISMISSAL With fees still due! *6 or more excused absences = Consideration for TEAM DISMISSAL XLR-8 Event Attendance Consequence Chart: Excused Unexcused *1 excused absence = NO PENALTY *1 unexcused absence = S-C Meeting *2 excused absences = S-C Meeting *2 unexcused absences = *3 excused absences = TEAM DISMISSAL Consideration for TEAM DISMISSAL With fees still due! ** Events are considered any performance or service activity outside of practice. *Multiple day events are considered one miss. Tardy Tardiness is heavily discouraged! Coaches will conduct a student-coach meeting for extreme tardiness or repeat cases. Communication between Coaches, Parents & Athletes: IT IS THE PARENT’S RESPONSIBILITY TO BE AWARE OF WHAT IS GOING ON WITH HIS/HER CHILD’S SQUAD! All information will be sent via email and/or text. All extremely important information (emergencies only) will be sent to parents via a handout at practice. We will most often use e-mail and text message to communicate weekly information. If your email is down or changes, it is your responsibility to advise an administrator of the change. No parents are allowed on the floor at any cheer/dance competition unless specifically requested by a coach. Parents should not contact the company hosting any competition for schedule, driving directions, or any other information. XLR-8’s coaching staff will hand out all needed information as soon as it becomes available to them. Additionally, parents are not allowed to register athletes in any other competitive events without the written consent of the Director, Britt Dawson. All conflicts or issues should always be conducted in a professional manner! Any parent who handles any concern (illness, injury, conditioning, discipline, conduct, coaching techniques, finance, attitude, etc…) in an inappropriate manner will force the athlete to be banned from the program indefinitely with fees still due! All issues should be directed to the coaching staff first! If the issue/concern is inappropriate for the coach to handle, the administrative officers are then next in line to voice your concern. After consulting the coaches and/or administrative officers, you may then consult the director via email or phone. Concerns directed to the director, that are made unaware to coaches and/or administrative members, will be ignored until otherwise complied. Parents are not allowed to confront coaches about MINOR issues immediately following a practice/event. Appointments must be scheduled for a later moment of discussion. Coaches have full authority to determine what issues are worthy of immediate conversation versus appointment. After the proper channel is utilized for addressing concerns, you can reach the XLR-8 Program Director, Britt Dawson by e-mail: xlr8allstars@gmail.com, or via cell (225)603-1858. General Rules for XLR-8 Squad Members TRAINING/WORKOUT TIME Attitude Attire Show respect to coaches & teammates Appropriate length shorts & shirt (NO mini shorts or super large t-shirts or school uniforms) Dance/Cheer shoes are a must! Hair pulled back out of face NO JEWELRY (Not even studs!) No long nails Drop Off No earlier than 15 minutes before practice time unless otherwise approved Please be ON TIME!!! Pick Up Parents are highly discouraged from taking participants from practice early without a note that has been approved by the coach! Lobby Area Please keep negative comments to yourself! Contact your coach or administrative officer with any problems & concerns. Please do not try to communicate with coaches or athletes during practice. COMPETITION TIME Show respect to coaches & teammates Come FULLY DRESSED in total uniform! (Hair bow/accessories… Coaches will typically remind you before each event.) Hair worn as instructed NO JEWELRY (Not even studs; unless apart of competition uniform) No long nails & No colored polish ON TIME & FULLY DRESSED! Please be ON TIME!!! Coaches will advise of meeting time & place at each event. Please respect the time that will be designated by your team’s coach. Please keep negative comments to yourself! This includes negative comments with reference to other teams and organizations! XLR-8 ALL-STARS – Participant Information Child’s Name __________________________________________________ Current Age ___________ School ____________________________________________________ Entering Grade 2015 _______ Date of Birth __________________________ Team Placement ________________________________ Full Address __________________________________________________________________________ Child’s Cell ___________________________ Child’s Email __________________________________ *** Mother’s Name _____________________________________ Cell ______________________________ Place of Employment & Profession ________________________________________________________ Mother’s Email ________________________________________________________________________ *** Father’s Name _____________________________________ Cell ______________________________ Place of Employment & Profession ________________________________________________________ Father’s Email ________________________________________________________________________ *** Emergency Contact Name __________________________________ Cell ________________________ Medical Information Physician’s Name ____________________________________ Phone ____________________________ Insurance Carrier _________________________________ Policy Number ________________________ Name of insured _____________________________ Relationship to participant ____________________ Does your child have any physical weaknesses or other important medical information/health problems? Please list: ____________________________________________________________________________ _____________________________________________________________________________________ I the undersigned parent/guardian of _________________________________ do give permission to XLR-8, that in the event we cannot be reached, and the emergency contact listed above cannot be reached, to contact and/or transport the above named participant to a physician, hospital, or healthcare provider, if the XLR-8 Staff believes that medical attention is necessary. Signature ________________________________________________________ Date ________________________ Agreement of Compliance Medical Treatment, Liability Release, and Appearance Agreement Advisor/Coach Director: An Agreement of Compliance must be read and signed by each participant and advisor/director in order to participate at a MOKA Cheerleading and Dance event. Please photocopy and distribute to each person attending the event. You must retain a photocopy of each completed form for your records and keep them with you throughout the event. First Name __________________________________ Last Name ______________________________ Date of Birth ______________ Social Security Number __________________ Gender Female Male Medical History of Participant – please check all that apply, and attach details/explanation if necessary Allergies Irregular menstrual Medications currently cycle taking Asthma Epilepsy/fainting spells Recurring sore throat/ear Diabetes infection Mental disorders Heart Trouble Migraine Headaches Medical conditions Contact Lenses Pre-existing injury currently under High Blood Pressure treatment currently being treated Convulsions Other _________________________________________________________________________________ I understand that I must be in full compliance with all MOKA Cheerleading & Dance Event/XLR-8 All-Star Program regulations to perform/participate in any manner. I also understand that any violation of this agreement may result in removal/disqualification of the team(s) or individuals involved. I agree that the information on this form is truthful and accurate to the best of my knowledge. Advisor/Coach: Each participant’s parent or guardian and each advisor/coach/parent chaperone must sign the following release for self. No participants will be allowed to participate in the event without all required signatures. I hereby release, waive, discharge and agree not to sue Avery D. Wilson, MOKA Cheerleading and Dance, XLR-8 AllStars, its operating facility, the instructors/staff, or any of its officers/agents (releasees), from all liability to myself, my personal representatives, assigns, heirs, for any and all loss or damage, and any claim or demands therefore on account of injury to my person or property or resulting in my death, now and forever, arising out of or related to participation and/or instruction in said course, activities, or any other operations that may occur, whether caused by the negligence of the releasees or otherwise. Additionally, I hereby assume full responsibility for any risk of bodily injury, death, or property damage, now and forever, arising out of related participation in any MOKA Cheerleading and Dance activity/operation. I understand that by taking part in any MOKA Cheerleading and Dance Event, there is a possibility of injury or sickness to my daughter/son or to me (advisor/coach/parent). I do hereby grant permission to hospital staff members to administer immediate treatment to my child should he/she be injured or to me (advisor/coach/parent). I give the right and permission to film, photograph, or video tape my daughter/son or me (advisor/coach/parent) for any reproductions associated or in any way connected with said televised, filmed, or printed event; in particular, reproduction for use in any form of advertisement for MCA/MDA promotional purposes. Parent(s) Full Name ______________________________________________________________________________ Address ____________________________________________ City _________________________ State _________ Zip ____________ Home Phone ( )___________________ Work Number ( )____________________ Email Address ______________________________ Insurance Carrier ________________________________ Phone ( )______________________ Policy/Group Number _______________________________ Signature of Participant _____________________________________________ Date ________________________ Signature of Participant’s Parent ______________________________________ Date ________________________ Advisor/Coach/Parent Chaperone ______________________________________ Date ________________________ “BE BOLD – BE GREAT – ACCELERATE” AUTOMATIC WITHDRAWAL FORM Authorization Agreement for Automatic Payment Withdrawal This authorization will remain in effect during my child’s or children’s enrollment with the XLR-8 All-Star Program, unless I cancel in writing, or otherwise dismissed from the program by the administration of the program. Cheerleader/Dancer’s Name ______________________________________________________________ Parent’s Name: ________________________________________________________________________ Parent’s Signature: _________________________________________________ Date: _______________ XLR-8 Authorization Signature: ______________________________________ Date: _______________ I authorize XLR-8 to make Automatic Withdrawals on the 8th of every month from: Banking Institution Name: ________________________________________________________________ Branch Location (City & State): ____________________________________________________________ Checking Account Number: ___________________________________________________ Routing Number: ____________________________________________________________ VOIDED CHECK HERE
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