Waiver | FLORIDA CHEER

Liability Waiver & Media Release

First Name of Athlete

Last Name of Athlete

Date of Birth

I grant permission to , and its agents and employees, to use photographs, video images and audio taken of my child at any facility or function for use in any and all marketing, public relations and advertising mediums used by Florida Panthers Cheer,LLC,, and to use such photographs, video images and audio in electronic versions of the same for any and all media distributions without notifying me.

Yes

Parent and/or Guardian'sInitials

Please specify anything we should know about

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

Parent and/or Guardian's Signature

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