CONSENT AND WAIVER

I hereby request the participation of my child, _____________________________,

in the Good Shepherd Rams Cheerleading Program. I understand that the
practices will primarily take place at Good Shepherd School and Our Lady of
Lourdes Parish and that my child will be under the supervision of a
designated Cheerleading coach throughout the season.

I hereby agree, on behalf of the named student and his/her other parent or
legal guardians, to waive any claims for liability against Good Shepherd
Parish, Good Shepherd School, Our Lady of Lourdes Parish, the Diocese of
Harrisburg or the CFA which may arise from the participation of the named
student in the above program.

______________________________________

(Print Parent’s Name)

______________________________________

(Parent’s Signature)

I have read and understand the Cheerleading Rules.

______________________________________

(Parent’s Signature)

______________________________________

(Cheerleader’s
Signature)

Date form returned: ________________________