Georgia Tech Cheerleading Alumni Program

Name *

First

Last

Email *

Phone Number *

Georgia Tech Cheerleading Program Years *

Homecoming 2024 | Letterwinner Tailgate & Alumni Program Field Access *

Unable to attend
Attending Letterwinner Tailgate & Alumni Program Field Access

Saturday, November 9th at Bobby Dodd Stadium

MBB vs Miami | GT Cheer Halftime Showcase *

Unable to attend
Attending MBB Halftime Showcase

Tuesday, March 4th at McCamish Pavilion

Alumni Brunch | GT Cheer NCA Showcase *

Unable to attend
Attending Alumni Brunch & NCA Showcase

Sunday, April 6th at McCamish Pavilion

Dietary Restrictions *

T-Shirt Size *

We are excited to offer an exclusive Georgia Tech Cheerleading Alumni shirt to the first 50 Alumni Program members of the 2024-2025 season!

Donation Confirmation: *

Click or drag a file to this area to upload.

Emergency Contact Name *

Emergency Contact Phone Number *

WAIVER OF LIABILITY, EXPRESS ASSUMPTION OF RISKS, HOLD HARMLESS & PHOTO RELEASE AGREEMENT *

In consideration of being permitted to participate in the Georgia Tech Athletic Association promotional activity known as Coach Shana’s Skills Camps & Clinics, I hereby agree as follows: I for myself and my estate, heirs, administrators, executors, and assigns, hereby release and hold harmless Shana Belden, the Georgia Tech Athletic Association, Georgia Institute of Technology, the Board of Regents of the University System of Georgia, the Georgia Tech Athletic Association Board of Trustees, the State of Georgia and their respective officers, directors, employees, representatives, agents, and volunteers (collectively, the “Releasees”), from any and all liability and responsibility whatsoever, however caused, for any and all damages, claims, or causes of action that I, my estate, heirs, administrators, executors, or assigns may have for any loss, illness, personal injuries included, but not limited, to sprains, strains, contusions, concussions, fractures, knee injuries, neck injuries, back injuries, death, or property damage arising out of, connected with, or in any manner pertaining to the activity, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or others, and assume full responsibility for my participation. I fully understand that there are potential risks associated with my participation in the activity, including, but not limited to, possible injury or loss of life. Despite the potential hazards associated with the activity, I wish to proceed, and freely accept and assume all risks, dangers, and hazards that may arise from my participation in the activity and that could result in loss, illness, personal injury, death, or property damage to me or to my property. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others. I further agree to defend, indemnify, and hold harmless Releasees from and against any judgment (including by third parties), settlement, loss, liability, damage, or costs, including court costs and attorney fees for both the trial and appellate levels, that Releasees may incur in whole or in part, directly or indirectly, known or unknown, foreseen and unforeseen, resulting in any way whatsoever from all activities arising out of the Event, whether caused by the negligence of the Releasees, or while participating in such activity or while in or upon the premises where the activity is being conducted. In signing this agreement, I acknowledge and represent that I have read and understand it; that I sign it voluntarily and for full and adequate consideration, fully intending to be bound by the same; and that I am at least eighteen (18) years of age, and willingly agree to comply with the stated and customary terms and conditions for participation in the activity, or I am the legal guardian of the consenting minor participant. I will participate in a safe and reasonable manner and if I observe any unusually significant hazards during my presence or participation, I will remove myself from participation and bring such hazards to the immediate attention of Shana Belden, or the nearest Georgia Tech official. Lastly, I grant Shana Belden, and the Georgia Tech Athletic Association (“Association”) all rights to use my photograph(s) from the Event in perpetuity for any and all marketing the Association engages in, and any and all publications, videos, websites, or other printed or electronic materials produced by the Association or its agents for the Association’s use and benefit. I understand that, by granting the Association these rights, I waive any claim or action of any nature arising because of, or in connection with, the photograph(s) and/or use of my photographic image(s). I have read this release of liability form. I fully understand its terms and sign it freely and voluntarily without inducement.

Participant E-Signature *

Date *

I am at least eighteen (18) years of age
I am the parent/legal guardian of the consenting minor participant (only needed if the participant is under 18)

Georgia Tech Cheerleading Alumni Program

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