In consideration for registration of my child listed above to the Mini Cub Camp and Panther Prep, I do hereby agree to release, discharge and hold harmless the St. Johns County District, its officers, agents, employees, volunteers, and booster organization from all causes, liabilities, claims, damages or demands resulting from injury or accident involving my minor child while attending camp. I understand that all participants must be covered by medical insurance and that the district does not provide such insurance for camp/clinic/tryout participants. *

We are excited to capture the fun and memorable moments at Cub Camp and Panther Prep! By acknowledging below , you grant permission for photos and videos taken during camp activities to be used by Nease Cheerleading. This may include, but is not limited to, use on our website, social media channels, brochures, and other marketing materials. If you do not wish for your child to be included in photos, you understand and agree to email neasecheerleadingtreasurer@gmail.comby July 1, 2026 with the subject line NO PHOTO USAGE in order to file your request. *

In the event of an emergency, requiring medical attention, I hereby grant consent to a physician, athletic trainer and/or other qualified medical personnel to provide medical treatment to and/or transport my child. I understand every effort will be made to contact me to receive my authorization before treatment will be undertaken. However, in the event on an emergency and if I cannot be reached, I give my consent to the medical care provider to perform any necessary emergency treatments, I agree to release any records necessary to the appropriate medical care provider for the purpose of treatment referral, billing or insurance. *

Participant Name (First and Last) *

Address *

Date of Birth *

Grade for 26-27 School Year *

Age at time of Camp *

Parent/Guardian Name (First and Last) *

Parent/Guardian Email *

Phone Number *

Alternate Emergency Contact Name and Phone Number *

Alternate Emergency Contact Relationship *

People authorized to pick up camper from camp *

Dietary Restrictions - A snack will be provided. If your camper has food allergies, please pack a snack that means their needs. *