KENNEDY
Cheerleading
2015 - 2016 Policies
Rylee Dil
Advisor & Coach
(510) 396-1607
[email protected]
Haley Durand
Assistant Coach
Dear JFK Cheer Candidate and Parents,
Thank you for your interest in JFK Cheer! Our team is committed to raising school spirit and pride. Throughout the
year, we will use our platform to promote interest in school functions and support school athletics. Aside from
leading in spirit, we also drive athleticism within our own program. Competitions and games are both opportunities
for us to instill teamwork and pride in a quality performance. We always strive for our personal best!
Being part of this program requires great energy, school pride and commitment. Developing an athlete to reach
his/her potential requires both physical and mental training. In this program participants will not only learn
cheerleading fundamentals, but will also be provided the tools to develop accountability, respect, leadership and
compassion. Be prepared to be your best self while with the Kennedy Titans Cheerleaders!
In this packet, you will find the 2015-2016 policies regarding eligibility, attendance, conduct, discipline and
expenses. Tryout information can be found at the end of this packet, followed by all necessary forms for participation
in the program. Please keep this packet to reference policies throughout the year. These policies have been
approved by Principal Edward Velez. Should you have any questions, please feel free to ask the advisor (email
address can be found below).
Sincerely,
Rylee Dil
Kennedy Cheer Advisor
(510) 396-1607
[email protected]
2
Eligibility
Cheerleaders must adhere to the following requirements in order to remain eligible. Ineligibility will result in immediate
dismissal. If a cheerleader is dismissed OR chooses to quit, she/he will not be eligible to tryout the following year.
Attendance: Cheer camp and competition clinic are both mandatory events- all cheerleaders must be in attendance in order
to participate on this team. Please find further details in “Schedule” on page 4. Cheerleaders must not be excessively tardy or
exceed absence limitations. More details in “Attendance” below.
Conduct: Exemplary behavior on and off campus must be upheld. Please see “Conduct” on page 5 for more details.
Grades: The advisor will verify grades after each grading period. Cheerleaders must maintain a minimum GPA of 2.0 with no
F’s. If a cheerleader’s GPA falls below 2.0 (but above 1.75) OR has one F, they will be put on probation until the next reporting
period. Cheerleaders may not be on probation for two consecutive periods- if a cheerleader on probation has a GPA below 2.0
(but above 1.75) OR has one F during the following grading period, they will be ineligible and dismissed from the squad. If a
cheerleader’s GPA is ever below 1.75 or has multiple F’s, they will be ineligible and dismissed from the squad with no
probation period. Grades are final once posted and changed grades will not be accepted.
Medical Clearance: Any limitations and/or chronic health problems must be disclosed. All cheerleaders must have a doctor’s
physical turned in to the advisor by Thursday, May 21st. This form is at the end of this packet.
Other Extracurricular Activities: Please see our policies under “Schedule” on page 4. Cheerleaders negligent of this
policy may be deemed ineligible and dismissed for safety reasons.
Attendance
Absences can be the downfall of a great cheerleading squad! If one or more squad members are absent from a practice or
game, the other members are forced to make last minute changes. This can be both stressful and dangerous.
JFK Cheer must be the first priority over all other extracurricular activities including, but not limited to:
 Other school involvements such as elective tutoring, drama, yearbook, journalism, leadership, and class offices.
 After school or weekend employment.
Notification: Each no call/no show will result in a strike. If a cheerleader will be absent or tardy, the cheerleader or parent
must call to notify the advisor as early as possible. If the cheerleader is sick, please call at least two hours before the event.
Excused Absences: Cheerleaders are allotted a maximum of three excused absences from May – August and a maximum of
six excused absences from September – March. Each absence beyond the allotted amount will result in a strike.
 Extreme illness (if you are feeling sick but still able to attend, activity at practice can be modified)
 Doctor ordered instructions for non-participation due to illness or injury. A doctor’s note is required for extended
nonparticipation. It is strongly recommended that athletes continue to attend practice to be aware of additions or
changes to a routine. As long as you are in attendance, absences will not be deducted from your allotted amount.
 School required grade-based obligation. This does not include tutoring, community service, projects or homework.
 Family emergencies (funeral, hospitalization, etc.)
 Pre-notified family vacation (minimum of two weeks’ notice)
Unexcused Absences: Each absence not considered excused will deduct from allotted absences AND incur a strike. In the
event of an unexcused absence from a game, the cheerleader will receive two marked absences (per one game) and incur a
strike. This policy applies during finals weeks – cheerleaders are responsible for managing school and cheer at all times.
Tardiness: Coming late or leaving early is disruptive. As a result, stunt training is interrupted and last minute changes to
routines may be required. For every seven times a cheerleader is late or leaves early, the cheerleader will incur a strike.
Tardiness to a game will result in benching during the first quarter of that game.
3
Schedule
Practice: We will practice three days a week. In the event of 3-day weekends, practice will move from Monday to Wednesday.
Calendars will be released throughout the year. Practice days and times may change as they depend on many factors.
 Spring Practices – From May 18th – June 9th, we will practice Mon, Tues and Thurs from 4 – 6:30 pm in the cafeteria.
 Summer Break – We will break from practice June 10th through July 5th. It really helps our team if family vacations are
scheduled during this time. Thank you very much in advance for your efforts to accommodate this.
 Summer Practices – We resume practice on July 6th. Practice will continue to be Mon, Tues and Thurs in the cafeteria
but may be slightly later due to coaches’ summer work schedules.
 Practices may be added in the event of necessary last-minute changes. Your flexibility is very much appreciated.
Tumbling: Every cheerleader will have an assigned day of the week to arrive early or stay late 30 min for tumbling practice.
Time Commitment: Please note that 3 practices and 1 game a week is a large time commitment. Cheerleaders and parents
should be aware and prepared. Furthermore, our season is long (May – March). School comes first, and it is very important for
our cheerleaders to maintain good grades. However, cheerleading is very reliant on all members being at every practice. It is
the cheerleader’s responsibility to balance schoolwork and cheer. Missing practice due to homework or studying reflects poor
time management and is not acceptable.
Cheer Camp and Competition Clinic: Camp is an extremely fun and rewarding event! We attend a sleep-away USA camp at
UC Santa Cruz. This camp is four full days, July 17th - 20th (Fri – Mon). Attendance of the entire event is mandatory. The team will
advance their skills, learn choreography and quickly form strong bonds with one another. We will also have a competition clinic
Aug 1st – 2nd (Sat – Sun). This event is two full days. The team will learn their competition routine. It is very intricate, which is
why it is critical that all members be present. You must be available for both camp and competition clinic in order to try out!
Games: Football games are on Friday or Saturday. Basketball games are usually on Wednesdays and/or Fridays.
Competitions: Competitions are an important aspect of this program as it facilitates development in many different areas.
Date(s)
Sun, November 8
Location
th
Type
Logan High School (Union City)
Regional
Merrill West High School (Tracy)
Regional
Sat, January 16th
Deer Valley High School (Antioch)
Regional
Sun, February 7th
UC Davis (Davis)
*March 17th – 21st
Anaheim Convention Center (Anaheim)
Sun, December 13
th
States
Nationals
As a result, your cheerleader will grow as an
athlete and as a person.
*Competition routines are extremely intricate! It
is very difficult and time consuming to
choreograph individuals in and out of this
routine. Therefore, it is crucial for all members to
be at every competition- please plan ahead.
*Regional and States dates are all final. Nationals dates are estimates and subject to change.
Other Extracurricular Activities: Splitting extracurricular time between cheerleading and other sports is a safety issue. It
is important that cheerleaders come to practice energized and well-rested, as they are required to lift others in the air. Because
of the time commitment that cheerleading demands, JFK cheerleaders will not be able to join other sports teams, including
spring sports and other cheer teams. Negligence of this safety rule will be grounds for dismissal.
*JFK Swimming is the only exception to this policy as the swim coach has agreed to allow a modified practice schedule for
cheerleaders. Policies for cheerleaders who choose to swim are:
 For safety reasons, cheerleaders cannot double up on athletic events in the same day. If they have cheer practice, then
they cannot then go and work out at swimming as well afterwards.
 Cheer events must always take precedent over swimming events.
 Cheerleaders must be aware of the major time commitment of two sports and manage their grades.
4
Conduct
By being a part of JFK Cheer, you are accepting the fact that your actions are more prominent than those not associated with
such an activity. Exemplary behavior is mandatory at all times, anywhere in the community and at all school functions where
you are recognized as a representative of JFK Cheer and Kennedy HS. Conduct and appearance must always exhibit the utmost
respect for self, school, and the cheer program. This includes in person AND via social media.
Proper conduct is outlined as follows:
 Be kind and respectful to others at all times regardless of outside influences.
 Always exhibiting good sportsmanship, despite the behavior of others.
 Never using profanities at cheer events, while at school, while in uniform or via any type of social media.
 Refraining from public displays of affection at cheer events, while at school and while in uniform.
 Adhere to proper appearance at all times. Cheerleaders should always be properly attired for practice upon arrival. No
jewelry or long nails at practice – these are safety issues. Uniform attire is required to be worn on all game days at
school, games and rallies. Cheerleaders will follow the school dress code on non-uniform days.
 Display exemplary behavior in practice and in class. This includes, but is not limited to, cooperation with and respect
for authority, punctuality, and the utmost moral integrity.
 In the event that there are two teams selected: If a JV cheerleader chooses to attend a Varsity game while in uniform,
the cheerleader must sit with the cheer coach. Upon changing out of uniform, the cheerleader may sit with whomever
he/she pleases granted that the cheerleader upholds good sportsmanship.
Discipline
Three Strikes Rule: One warning will be given for minor infractions. In the event of a serious infraction, the warning will be
skipped and one strike will be given. Whether an infraction is minor versus serious is at the discretion of the coaches.
 First strike – cheerleader will be notified.
 Second strike – cheerleader and parents will be notified.
 Third strike – will result in dismissal from the squad.
Strikes will occur for the following infractions:
 Any behavior contrary to the proper conduct mentioned above (see “Conduct” section)
 Loaning any cheer related clothing to those not participating in JFK Cheer (friends, significant others, etc.)
 Unexcused absences OR excessive use of excused absences (see “Attendance” for more details)
 Improper or disrespectful behavior toward advisor, coaches, or other designated authority
 Suspension from school or other serious disciplinary action taken by JFK administration
Immediate dismissal: As stated in FUSD policy, use of tobacco products/alcohol/illegal drugs AND improper use of
prescription drugs will each result in immediate dismissal from the squad. If it is reported that any of the above behaviors are
being conducted while a representative of JFK Cheer, a conference with the administration and/or parents/guardians may be
held to determine validity and possible dismissal. This policy is not limited to uses during school or cheer events.
Disregarding JFK Cheer’s policy on extracurricular activities is grounds for immediate dismissal. (Please see page 4)
Each case of discipline will be judged individually. Every attempt will be made to discipline fairly and to make consequences of
actions known ahead of time. The advisor, with the assistance of the administration if deemed necessary, has the final decision
in any discipline.
5
Expenses
New Member: $950
Includes: Uniform (shell, skirt, bodyliner, briefs); Warm Ups (jacket, pants); Poms, shoes, bows, backpack; Practice/Camp
clothes (four sets of shirts/shorts); Cheer Camp
Returning Member: $617
Includes: Uniform (shell, skirt); Poms, bows; Practice/Camp clothes (three shirts); Cheer Camp
*Please note: If returning cheerleaders need any replacement items not listed above (ex. new shoes), expenses will increase.
Team Expenses: Regional & State competition registration fees; Music and miscellaneous items such as posters, signs,
awards; End of the year banquet. Team fundraisers will be used to cover these costs.
Ways to cover expenses:
1. Covering your cheerleader’s costs: checks may be made to JFK Cheer. Non-profit Tax ID # is available when donation is
made. Payments for non-tangible items are tax-deductible (i.e. camp, competitions). Payments towards tangible
items are not tax-deductible (i.e. attire, accessories).
2. Sending sponsorship letters to family, friends, and/or businesses. These letters will be provided after tryouts.
3. The Guy Emanuele Sports Fund (via Fremont Education Foundation) helps pay for up to $200 in expenses. Parents,
please visit www.fremont-education.org to print out the application.
4. Fundraising (iPad raffle, first aid kit sales, car washes, chocolate sales, reusable bag sales)
Ideas for fundraisers and help coordinating fundraisers are always welcome!!
Parents are not required to financially contribute. However, cheer is a very costly sport and it is in the best interest of the team
that families cover as much of their cheerleader’s expenses as possible. Competing will only be possible as long as the team
has the financial resources to support music, props and registration costs. Please also note that any products that are purchased
with fundraised monies are considered school property and must be returned at the end of the cheer season.
Time Sensitivity: It is important to raise funds in a timely manner since many cheer expenses occur early in the season.
Camp fees are due immediately, attire must be ordered quickly to receive them on time for camp and uniforms must be
ordered ASAP so they are received before football season. If you are able to cover your cheerleader’s costs in full, it is greatly
appreciated. If this is a financial hardship, you are more than welcome to split contributions into the following increments:
Expense:
Date Collected:
New Cheerleaders
Returning Cheerleaders
CAMP CLOTHES, SHOES, BOWS,
BACKPACK & POMS
May 18th
$200
$85
CHEER CAMP
UNIFORM & WARM UPS
June 8th
$410
$410
July 6th
$340
$122
Nationals Expenses: Our trip to Nationals will be an extremely exciting and rewarding experience. The team will be
representing Kennedy High School in this multiple day event in Anaheim, CA. We will also spend one day at Disneyland as a
team to celebrate the end of our season. It is very important to keep in mind that this is a school field trip for an athletic eventnot a vacation. This trip is tentative upon the performance of our team, as well as acquiring sufficient funds. We will discuss
details and expenses closer to the event. Please ensure that your calendar is blocked off for this event.
6
Clinics and Tryouts
Tryout Clinics will be Tuesday, Wednesday and Thursday, May 12th – 14th
Tryouts will be held following clinics on Thursday, May 14th
Eligibility: All candidates must be eligible in order to tryout. Please see “Eligibility” on page 3.
Forms: Forms are at the end of this packet and are due to the advisor on the first day of clinics. You may not tryout if
all forms have not been submitted. If you are placed on a team, the physical will be due by no later than Thursday,
May 21st.
 Student/Parent Permission & Agreement
 Liability Release Form
 Cheer Candidate Background Form
 JFK Athletics Clearance Form
 Physical Evaluation Clearance (Due 5/21)
Clinic & Tryout Attendance: Punctual attendance is required at all clinics and tryouts. It is highly recommended
that participants attend all clinic days as we will be teaching new material each day.
Location: Clinics and tryouts will be held in the Kennedy cafeteria, located in the back of the school. These events are
closed to the public (as are practices). Thank you in advance for your understanding.
Clinic and Tryout Attire: Participants should wear shorts, a tank top or t-shirt, and athletic sneakers. No
sweatpants, sweatshirts, spaghetti straps, or midriff tops. Returning spirit leaders should not wear any JFK Cheer
clothing. Hair should be tied up into a neat ponytail and pinned away from the face. Nails should not extend past
fingertips. Please refrain from chewing gum or wearing jewelry to clinic or tryouts. This includes necklaces, any
piercing(s), watches, bracelets, etc.
Material: Over the course of the clinic, candidates will be taught one cheer and one dance. No returning members
have been exposed to the material. Different material will be taught each day, so attendance is crucial. Individual
assistance is always available- don’t be afraid to ask! Candidates will also be given the opportunity to demonstrate
other skills during their tryout. We will review these skills and proper technique during the clinic.
Returning Cheerleader Evaluation: Throughout the season, coaches and advisors become very familiar with each
athlete’s attitude and technical skills. Many important variables are hard or impossible to measure during tryouts- the
evaluation criteria below provides a way for us to take knowledge of what a particular cheerleader contributed the
previous year and include it as a percentage of her tryout score. The evaluation may have a substantial impact on the
final score and placement for the following season.
7
Tryout Results
Squad Selection: Cheerleaders could be selected for up to 2 game squads – JV and Varsity. Alternatively, we may
form one team referred to as JFK Cheer.
The squad(s) selection will be posted by 10 am, Saturday May 16th. All results are final and non-negotiable. Judging is
conducted with the highest standards of fairness and accuracy. If you are discontent with your squad placement and
choose to quit, you will not be eligible to try out for JFK Cheer the following year.
First Practice & Fittings: Following tryouts, we will have our first practice on Monday, May 18th at 4:00 pm in the
cafeteria. At this practice, cheerleaders will sign up for a fitting appointment. We will be conducting fittings from 5 –
7:30 on Wednesday, May 20th. Please be sure to wear tight, spandex shorts and a sports bra, as you will be trying on
sample sizes in front of others.
SUNDAY
May 10
MONDAY
11
TUESDAY
12
Kick-Off
Meeting
7 pm
17
18
First $
Contribution
First Practice
4 – 6:30
WEDNESDAY
13
THURSDAY
14
15
Clinics
4 – 6 pm
Clinics
4 – 6 pm
Tryouts 6 pm
21
22
Clinics
4 – 6 pm
19
20
Practice
4 – 6:30
Fittings by
Appointment
5 – 7:30
FRIDAY
SATURDAY
16
Results
Posted
10 am
23
Physical Due
Practice
4 – 6:30
8
JFK Cheer Tryout Score Sheet 2015
Candidate Name:
Candidate #:
Category
Point Scale
Cheer Execution





Excellent = 12-13
Good = 9-11
Average = 6-8
Weak = 3-5
Poor = 0-2
Knowledge of routine
Strength of movements/sharpness
Pace/timing
Clarity of words (annunciation, tempo)
Voice projection
Dance Execution




Excellent = 12-13
Good = 9-11
Average = 6-8
Weak = 3-5
Poor = 0-2
Excellent = 12-14
Good = 9-11
Average = 6-8
Weak = 3-5
Poor = 0-2
Knowledge of routine
Motion placement
Strength of movements/sharpness
Timing
Showmanship




Confidence
Spirit & enthusiasm
Eye contact/facial expression
Audience appeal
Jump #1: Toe Touch





Sharp motions prep and jump
Chest and head up, arms in a “T” motion
Rotated legs so that knees face backwards
Pointed toes
End with feet together
Jump #2: Hurdler, Herkie or Pike





Judge:
Sharp motions prep and jump
Chest and head up, arms in a “T” motion
Rotated legs so that knees face backwards
Pointed toes
End with feet together




/20
/10
/5
Excellent = 5
Good = 4
Average = 3
Weak = 2
Poor = 0-1
/5
Skill(s) Shown:
Balk walkover
Front walkover
Back handspring
Front handspring
Toe touch back handspring
Round-off back handspring
Back handspring series


Flexibility

/20
Excellent = 5
Good = 4
Average = 3
Weak = 2
Poor = 0-1
Tumbling







Score

Bridge (shoulders over wrists, legs together and
straight)
Scorpion (locked out bottom leg, foot above head)
Scale (both legs locked, toe pointed, high V)
Heel Stretch (both legs locked, toe pointed, high V)
Bow and Arrow (both legs locked, toe pointed, arm
through gap in a “T” motion)
Section II

One bonus point for each skill
½ point for each skill
performed with compromised
technique.
Maximum of 5 bonus points
awarded
Please showcase your
highest level skills.
Bonus Points Awarded:
/5
/60
9
JFK Cheer Tryout Score Sheet 2015, New Candidate
Candidate Name:
Candidate #:
Category
Point Scale
Grades:

3.8-4.0 = 10
3.6-3.79 = 9
3.4-3.59 = 8
3.2-3.39 = 7
3.0-3.19 = 6
Based on your GPA
JFK: Semester 3 Final Grades
Walter’s: 3rd Quarter Grades
Teacher Evaluations:
The following attributes will be evaluated via email





Attendance/Punctuality
Attitude/Cooperation
Dependability/Responsibility
Leadership/Teamwork
Work Ethic
Well thought-out answers
Sincere
Articulate
Overall Attitude (happy, positive energy)
Appearance & Attitude:






Hair tied back & pulled away from face
Appropriate clothing/shoes
No jewelry/No gum/Nails trimmed
Initiative/eagerness to learn & help others
Work ethic, focus
Enthusiasm/energy
Meeting & Clinic Attendance:




Interview:




Advisor: Rylee Dil
On time (and prepared to start – not fixing hair,
changing clothes, taking off jewelry)
Stays the entirety
Section I
Section II
Overall Score
2.8-2.99 = 5
2.6-2.79 = 4
2.4-2.59 = 3
2.2-2.39 = 2
2.0-2.19 = 1
Candidates will be evaluated on a 5point scale for each attribute.
Scores will be averaged together and
multiplied by 2 to determine the
overall score.
Score
/10
/10
Excellent = 9-10
Good = 7-8
Average = 5-6
Weak = 3-4
Poor = 0-2
/10
Excellent = 6
Good = 5
Average = 3-4
Weak = 1-2
Poor = 0
/6
1 point for kick off meeting
1 point for each clinic day
/4
/40
/60
/100
10
JFK Cheer Tryout Score Sheet 2015, Returning Candidate
Candidate Name:
Candidate #:
Category
Point Scale
Grades:
3.8-4.0 = 10
3.6-3.79 = 9
3.4-3.59 = 8
3.2-3.39 = 7
3.0-3.19 = 6
Based on your GPA
JFK: Semester 3 Final Grades
Walter’s: 3rd Quarter Grades

Teacher Evaluations:
Score
2.8-2.99 = 5
2.6-2.79 = 4
2.4-2.59 = 3
2.2-2.39 = 2
2.0-2.19 = 1
/10
Excellent = 9-10
Good = 7-8
Average = 5-6
Weak = 3-4
Poor = 0-2
Each evaluation score is an average of five criteria
Sum all evaluation scores to get the total score


Advisor: Rylee Dil
/10
Returning Cheerleader Evaluation
Efforts to be punctual and prepared:
0
0.5
1.5
2.0
2.5
3.0
3.5
4.0
2.5
3.0
3.5
4.0
2.0
2.5
3.0
3.5
4.0
2.0
2.5
3.0
3.5
4.0
3.0
3.5
4.0
Positive, encouraging and optimistic attitude:
0
0.5
1.5
2.0
/20
Respect towards teammates, coaches and advisors:
0
0.5
1.5
Overall stunting technique and safety:
0
0.5
1.5
Timely efforts to practice and memorize choreography:
0
0.5
1.5
2.0
2.5
Meeting & Clinic Attendance:


On time (and prepared to start – not fixing hair,
changing clothes, taking off jewelry)
Stays the entirety
Section I
Section II
Overall Score
Subtract:
Deduct 1 point for each day missed
/40
/60
/100
11
Student/Parent Permission & Agreement
My child, __________________________________, has my permission to be a cheerleader (JV, Varsity or JFK
Cheer) at Kennedy High School for the 2015-2016 cheer season. I understand that he/she must abide by the rules and
regulations of the JFK Cheer Policies set by the cheer advisors, coaches and key administrators of Kennedy High
School. I have read the JFK Cheer Policies and understand that the violation of any of these rules may lead to
temporary suspension or permanent dismissal from the squad. All disciplinary and academic issues will be resolved
by the advisor separately and privately. I understand that all forms must be completed and submitted by Thursday,
May 14th at 5:30 pm or my child will not be allowed to try out. I understand my child will be evaluated by qualified
judges and we agree to abide by their decision.
I have discussed the time obligation with my child. I understand that cheer activities take priority over all nonacademic involvements and that, as a team member, my child must be present at all functions and practices. I
understand that the lack of attendance/punctuality will result in benching at games, suspension or dismissal.
By signing this document, I am stating that my child and I are ready to make the commitment to be members of JFK
Cheer and accept the conditions of all 2015-2016 JFK Cheer Policies.
________________________________________________
Parent/Guardian Signature
__________________
Date
________________________________________________
Parent/Guardian Printed Name
I am interested in being a cheerleader and I understand the risks stated. I have read the JFK Cheer Policies and
promise to abide by all rules and regulations stated. I promise to cooperate and follow all instructions of the coaching
and advising staff. I understand that I am solely responsible for remaining eligible throughout the year.
________________________________________________
Student Signature
__________________
Date
________________________________________________
Student Printed Name
*You may wish to make a copy of this form for your records
12
INFORMED CONSENT AND ACKNOWLEDGEMENT AGREEMENT
WARNING!
Cheerleading is a vigorous, physical activity involving motion, rotation and height in a unique environment
and as such carries with it a higher than ordinary risk of injury. Be advised that serious, catastrophic injury,
paralysis or even death could occur particularly if a participant were to land on his/her head, neck or back!
I/We, ______________________________, parents and/or legal guardians of _____________________,
who is a student at Kennedy High School and wishes to participate in their cheerleading program, voluntarily give our
consent for such participation by our son/daughter.
It has been adequately explained to us that cheerleading is an activity that may involve airborne inversion of
the body and therefore there is an increased potential that any of the routines involving our son/daughter’s
participation could lead to serious injury, paralysis or even death.
We understand that the activities in which our son/daughter will be asked to participate are strenuous and
require physical and athletic agility. It has been fully explained to us that these activities include, but are not
necessarily limited to a variety of gymnastics maneuvers, including somersaults, back handsprings and aerials; that
there will be a variety of mounts, tosses, and stunts requiring the coordination of more than one participant on the
squad; and that these activities will not be confined to any one site or venue, but rather will involve a variety of sites
or venues throughout the year.
I agree to disclose any and all of my child’s limitations and/or chronic health problems to the advisor for my
child’s safety. We have been informed that our son/daughter must be examined by a physician prior to participation in
these activities and we agree to such examination. We are aware that our son/daughter must be granted medical
clearance in order to participate. We are aware that this physical examination should be turned in no later than
Thursday, May 21st. We further agree to immediately notify the advisor in the event of any change in our
son/daughter’s health status. We will get medical clearance for our child if requested at any point throughout the year.
We also understand that our son/daughter may be required to travel to locations off campus for the purpose
of participating in cheerleading activities and the appropriate school personnel may provide that transportation to
him/her. We consent to such school sponsored transportation.
We agree to, and by signing this agreement, release the coaches, advisors, volunteers, staff of Kennedy
High School and the Board of Education from any claim of negligence by ourselves, our son/daughter, our heirs,
executors and assigns, from any liability arising from claims for damages for injury to our son/daughter and any
claims for loss of or damage to his/her property which may arise out of his/her participation in this school sponsored
program for the 2015-2016 academic year.
In witness whereof, I/we have affixed my/our signature/s to this agreement.
_________________________________________________________
(Parent’s and/or legal guardian’s signature)
___________________
(Date)
_________________________________________________________
(Parent’s and/or legal guardian’s signature)
___________________
(Date)
13
Cheer Candidate Background
Candidate Name:
Please clearly list ALL of your current teachers’ last names and subjects:
Teacher
Subject
Any previous cheer teams are eligible to be listed below:
Number of
Years
Age(s) at
the Time
Organization
(FFL, all-star gym)
Team
(FFL team, allstar level)
Coach & Contact Info
(Phone & Email)
Hours
Per
Week
Any previous tumbling/gymnastics teams or classes are eligible to be listed below:
Number
of Years
Age(s)
at the
Time
Organization
(ie. Name of
gym)
Did you
compete?
Gymnastics
or
Tumbling?
Name/Level of Class
OR
Competitive Level
Hours
Per
Week
14
John F Kennedy High School Athletic Department
Clearance Form
Section 1
Athletes Name:
Section 2
Last:
First:
DOB:
Address:
MI:
(MM/DD/YYYY)
City:
St:
Home Phone:
(
-
(
)
-
Student ID:
Grade: 9 ☐ 10 ☐ 11 ☐ 12 ☐
Sex:
Please place an X next to the sport you are trying out for.
Fall Season
Winter season
☐ Cross Country
☐ Boys Basketball
☐ Football
☐ Girls Basketball
☐ Girls Tennis
☐ Boys Soccer
☐ Girls Volleyball
☐ Girls Soccer
☐ Cheerleading
☐ Wrestling
Spring Season
☐ Baseball
☐ Golf
☐ Boys Tennis
☐ Softball
☐ Swimming
☐ Track
☐ Badminton
Zip:
Cell Phone:
)
Athletic Director: Paul McDermott
Check Sport(s) of Participation: (Form must be filled out for each
sport participating in.)
Male ☐
Female ☐
Email:
Medical Conditions:
Heart Condition?
Asthma? (Please bring an inhaler)
Diabetes?
Allergies?
Convulsions?
Other? Explain:
Section 3
Y
Y
Y
Y
Y
/
/
/
/
/
N
N
N
N
N
Section 4
Parents/Guardian Information (Please print clearly)
Medical Insurance Verification
Father ☐, Mother ☐, Grandparent ☐, Other Legal Guardian ☐
Last:
First:
($1,500.00 minimum medical insurance coverage is required. Supplementary
medical insurance may be purchased by students/families.
Information is available in the Athletic Director’s office).
Address:
Insurance Company:
City:
St:
Zip:
Address:
Phone:
City:
Home: (
)
-
Work: (
)
-
Cell: (
)
-
Phone: (
)
*Would you like email updates sent to this email address? Y / N
Father ☐, Mother ☐, Grandparent ☐, Other Legal Guardian ☐
Last:
First:
Group number:
Hospital:
Policy Number:
Address:
City:
St:
)
-
Work: (
)
-
Zip:
Cell: (
)
-
E-mail:
*Would you like email updates sent to this email address? Y / N
If you cannot be reached in case of an emergency please give us a second
contact name and phone number:
Last:
First:
(Relationship:
)
)
Section 5
)
-
Physician:
)
/ Other: (
)
Consent - Medical Treatment/Permission to Play
Phone:
Home: (
/ Other: (
St:
Phone: (
Address:
City:
-
Zip:
ID Number:
E-mail:
Phone: (
St:
Zip:
-
My child has my permission to participate in interscholastic athletics. I
request that my child receive first aid services whenever such services are
deemed necessary. I authorize that my child be attended by a physician and/or
be taken to the nearest hospital in the event that such treatment is deemed
necessary. I will accept the judgment of the person in charge of the activity. I
further acknowledge that I have read and understood the ‘Warning to Students
and Parents’ section concerning the risks involved with participation in
interscholastic athletics. I, as the athlete, give my permission to receive first
aid services whenever deemed necessary.
Preferred Hospital or Facility: (When practical)
Section 6
Acknowledgement of the KHS Athletic Code (posted online) and concussion packet we have read and understand the concussion
form provided by the school in the sports packet. For current and up-to-date information on concussions I can go to:
http://www.cdc.gov/concussionInYouthSports/
We hereby acknowledge that we have read and understand the KHS Academic regulations that govern eligibility of prospective student-athletes. We also
acknowledge the ‘Warning to Student-Athletes and Parents’ of risk of Athletic participation. John F Kennedy High School competes in the MVAL, which
is a member of the North Coast Section and California Interscholastic Federation, therefore we must meet the academic, athletic, citizenship and
residential requirements included herein and agree to abide by them. We also understand that competing in athletics is a privilege and not a right; if just
cause can be shown it can be revoked at any time.
___________________________________________________________________________________________________________________________
Parent Signature
Date
Student-Athlete Signature
Date
15
Physical Evaluation Clearance Form
Name: __________________________________________
SEX: M
F
Date of Birth: ________________
 Cleared for Cheerleading without restriction
 Cleared without restriction with recommendations for further evaluation or treatment for:
______________________________________________________________________
 Not Cleared
Recommendations:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
I have examined the above-named student and completed a physical examination. The athlete does not present
apparent clinical contraindication to practice and participate in cheerleading as outline above. A copy of the physical
exam is on record in my office and can be made available to the school at the request of the parents. If conditions
arise after the athlete has been cleared for participation the physician may rescind the clearance until the problem is
resolved and the potential consequences are completely explained to the athlete (and parents/guardians).
Physician Name (please print): ___________________________________________________________
Address: ___________________________________________________________
Phone: ___________________________________________________________
_____________________________________________________________________________________________
Physician Signature
Date
EMERGENCY INFORMATION:
Allergies:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Other information:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
16