University of Nebraska Kearney

UNK CHEER AND DANCE
SHAKE IT UP
KIDS CAMP

4-6pm, Health and Sports Center - Cushing Coliseum

6pm performance at UNK Women's Basketball

Acknowledgment of Risk and Waiver of Liability 

 ***Please carefully and completely read the following statements concerning participation in the UNK Spirit Squad Kids Camp. It has the effect of limiting your legal rights and releases the Board of Regents of the University of Nebraska, the Nebraskan Student Union, any spirit squad members, coaches or advisors, University Student Affairs and UNK Athletics from any legal liability resulting from participation in this event. *** 

· I, the undersigned parent or legal guardian, do herby grant permission for my son/daughter to participate in the UNK Spirit Squad Kids Camp.  

· I further acknowledge and understand and agree that by participating in the camp, there is a possibility of physical illness or injury and by giving my consent for their participation I herby assume all risk of such injury related to my son/daughter’s participation. 

· I, hereby authorize any representative of the UNK Spirit Squad Kids Camp or the event party to authorize any medical attention or treatment by qualified and licensed medical personnel which maybe becoming necessary for my son/daughter. 

· I understand that I will be notified as soon as possible in the event of an emergency. All expenses of such treatment will be assumed by me or my insurance company. 

· I represent to you that, to the best of my knowledge and belief, my child has no physical, medical, mental disability or other limitation that would restrict his/her ability to fully participate in this activity. 

· I hereby voluntarily and knowingly assume all risks and agree to hold without any liability to the Board of Regents of the University of Nebraska, the University of Nebraska at Kearney, the Nebraskan Student Union, any spirit squad members, coaches or advisors, University Student Affairs and Athletics, their agents, and/or representatives of any of these bodies, and all other concerned parties of any of these groups. 

· I understand and hereby allow the UNK Spirit Squad to use my dependant’s photograph for promotional efforts without the expectation of any reimbursement. 

 **By typing in the box below you are providing an electronic signature** 

Parent/Guardian Signature  Date  

(entries must be received by February 14 to receive the t-shirt) 

 
REGISTRATION FORM 

Participants Name:  Age:   

Date of Birth:  

Grade (if in school)  

Parent/Guardian Name:   

Phone: 

Address:  City  State   

Zip  

Parent/Guardian E-mail:  T-Shirts Size (youth sizes)  S, M, L, XL, XXL  

Emergency Contact:  Relationship:    

Phone:  

Notes for camp staff:   

 
BASKETBALL TICKETS 

(Camp participants do not require tickets.  UNK Athletics is providing two complimentary tickets to individuals you list below.  Tickets will be available at the will call window.  Additional tickets may be purchased at the door for $4 or by contacting 865-1563.) 

First and last names of individuals receiving complimentary tickets:
1. 2.  

PAYMENT 

$25 check (make checks payable to the UNK Spirit Squad)
$25 cash 

 You can mail or drop off payment to:
 Nebraskan Student Union
 1013 West 27th St
 Kearney NE  68849 

Questions?  Call 308-865-8523