Cheerleader's Name (First, MI, Last):

Address:      Birth Date (MM/DD/YYYY):

City, Zip:      Age (as of July 31, 2008):     

Phone:                                                     Grade In Fall 2008: 

Subdivision:                                             School Attending 2008: 

Parent/Legal Guardian Information

Do you have Personal or Group Insurance? Yes  No  (If yes, then complete the following)       

Name of Insurance Company: 

Name of Insured: 

Employer: 

Please list all pertinent medical information, physical limitations, problems or special needs:

Emergency contact (other than parents):

Phone #:              Relationship: 

Previous Season Data:

Did player cheer in KFL last season?  Yes  No      If yes, what team?

Team Request/Cheer Friend Request: 

Sibling participant Name:   Age   Football Cheerleading

*Important:

In order to guarantee that your order is linked to your payment, please provide the following information:

Name on credit card used for payment