Regional Individual Registration Form
SSAP, Inc. • PO Box 460208•Garland, TX 75046-0208
Ph. 972 414-0804 Fax 972 675-9163
ssap.inc@verizon.net
http://www.ssapcheernmore.com
Competitions will be held in the following Cities and States. You may choose a location of
your choice however you may only participate in one Regional Competition only!
City/State Date Location
1. Shreveport, LA October 21, 2006 Southern University At Shreveport
3050 Martin Luther King Dr
Shreveport, LA 71107
2. Lake Charles, LA November 4, 2006 Washington-Marion H.S.
2802 Pineview Street
Lake Charles, LA 70615
3. Houston, TX November 11, 2006 Kashmere H. S.
6900 Wileyvale Road
Houston, TX 77028
4. Dallas, TX December 2, 2006 TBA
5. Port Arthur, TX December 9, 2006 Memorial High School
2200 Jefferson Dr.
Port Arthur, TX 77642
6. Nationals, Dallas, TX March 3, 2007 TBA
7. Hampton, VA TBA TBA
8. Atlanta, GA TBA TBA
9. San Diego, CA TBA Mission Bay High School
2475 Grand Avenue
San Diego, CA 92109
5
SSAP, Inc.
“Helping America’s youth become the best they can be in sports and education.”
Regional Individual Registration Form
SSAP, Inc. • PO Box 460208•Garland, TX 75046-0208
Ph. 972 414-0804 Fax 972 675-9163
ssap.inc@verizon.net
http://www.ssapcheernmore.com
_____/______/_____
*Competition Locations & Dates:
Please list location you are entering below:
_____________________________________________________________________________________________
Location and date
For all other locations please check out our website
[] Cheer Competition [] Jump Competition [] Tumbling Competition
Dance Competition
[] Dance Team Jazz/ Funk [] Dance Team High Kicks [] Dance Team Twirling
[] Dance Team Novelty/Prop [] Dance Team Lyrical [] Dance Team Flag
*Participants Name: ____________________________________________________________________ [] M [] F
Last First MI
*Address: ___________________________________________________________________________
City state zip
*Contact number (s) Hm ( ) ________-__________ wk/cell ( ) ________-_________
*E-mail: __________________________________________________________________________
Please print clearly
*DOB: ____/_____/19____ _____________ __________
Present age grade
*School: ________________________________________________ [] Elementary [] Middle [] High
*School Address: ___________________________________________________________________________
City state zip
Phone: ( ) ________-________
Registration fee $20.00 per participant (Due three days before competition). $25.00 registration fee on the day of competition.
NO EXCEPTIONS!
In Case of an Emergency call
* Name: ____________________________________________________________________ _____________________
Last First MI Relationship to participant
*Address: ____________________________________________________________________________________________
City state zip
6
SSAP, Inc.
“Helping America’s youth become the best they can be in sports and education.”
Regional Individual Registration Form
SSAP, Inc. • PO Box 460208•Garland, TX 75046-0208
Ph. 972 414-0804 Fax 972 675-9163
ssap.inc@verizon.net
http://www.ssapcheernmore.com
*Contact number (s) Hm ( ) ________-__________ [] wk [] cell ( ) ________-_________
Please make sure to turn both registration and liability form in at the same time all forms not received may result in a delay.
RELEASE OF LIABILITY
READ THIS CAREFULLY BEFORE SIGNING:
AGREEMENT TO ASSUME RISK AND RELEASE FROM LIABILITY
As consideration for being a participant in the Strength, Speed, & Agility Program, Inc. Cheerleaders
Competition (hereinafter "Competition"), and any and all possible resulting and Halftimes, I, the parent or
guardian, hereby (1) release the Strength, Speed, & Agility Program, Inc. all related rehearsal sites and any
officers, directors, members, employees or agents (collectively, the "Released Persons") from all actions,
claims, or demands that I, my assignees, heirs, guardians, and legal representatives may have now or in the
future, including those for personal injury or property damage resulting from the negligence of any Released
Person, arising out of my child’s participation in the Competition, and/or Halftime(s), and (2) agree that I, my
assignees, heirs, guardians, and legal representatives will not make a claim against or sue any Released Person
for personal injury or property damage resulting from my child’s participation in the Competition, and/or
Halftime(s), including that which results from the negligence of any Released Person. In addition, I, the parent
or guardian, irrevocably consent to the reproduction and use of any photographs, tapes, or other recordings of
my child’s likeness ("Recordings") made by any Released Person or the media, and I, the parent or guardian,
agree that any reproduction or use of such Recordings will be without compensation to my child. I, the parent
or guardian, agree that all judges decisions are final arising out of my child’s participation in the Competition,
and/or Halftimes.
I, THE PARENT OR GUARDIAN, AM AWARE THAT THE COMPETITION, AND/OR COMPETITION HALFTIME(S) MAY BE
RECORDED. I, THE PARENT OR GUARDIAN, AGREE TO ACCEPT ALL RISKS OF PERSONAL INJURY AND PROPERTY DAMAGE.
I AM ______________________________________`S PARENT/LEGAL GUARDIAN, AND ACTING IN THAT
CAPACITY, I HAVE CAREFULLY READ, AND I AGREE TO THIS RELEASE.
*______________________________________ *( ) __________________-___________
Participants Name Phone Number
*_______________________________ _____________________________________
Address City, State, Zip
_______________________________ ( ) _______________-______________
School Attending School Phone Number
*______________________________________ ______________________________________
Parent/Legal guardian Signature Relationship
7
SSAP, Inc.
“Helping America’s youth become the best they can be in sports and education.”
Regional Individual Registration Form
SSAP, Inc. • PO Box 460208•Garland, TX 75046-0208
Ph. 972 414-0804 Fax 972 675-9163
ssap.inc@verizon.net
http://www.ssapcheernmore.com
Regional Winners:
Cheerleaders Division:
1st – 3rd place winners will receive a trophy
Co-ed Division:
1st – 3rd place winners will receive a trophy
Dance/Drill Division:
1st – 3rd place winners Pop/Hip Hop will receive a trophy
1st – 3rd place winners Jazz/Modern, Lyrical will receive a trophy
1st – 3rd place winners Novelty/Prop will receive a trophy
1st – 3rd place winners High Kicks will receive a trophy
1st - 3rd place winners Flag will receive a trophy
1st – 3rd place winners Twirling will receive a trophy
Step-Team Division:
1st – 3rd place winners will receive a trophy
Individual Division:
1st and 2nd place winners will receive a trophy
All participants receive a medal for participation!
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SSAP, Inc.
“Helping America’s youth become the best they can be in sports and education.”