CHEERLEADING TRY-OUT PACKET
MILES COLLEGE
CHEERLEADING TRY-OUT PACKET
2011-2012
Thursday, August 18, 2011-Saturday, August 20, 2011
Dear Candidate,
We are very excited that you are interested in becoming a part of the Miles College 2011-2012 Cheerleading Squad. Currently, the squad participates in a variety of activities such as community service, cheering at the football, basketball games as well as taking part in competitions. As a cheerleader for Miles College, one must be dedicated and determined and be prepared to work to their full potential at ALL times.
Please complete and submit the cheerleading try-out packet before Friday, August 12, 2011. Packets can be mailed to the address listed below. If there is any additional documentation that is needed, you will be notified. We look forward to working with you during try-outs and hopefully for the upcoming season. If you have any questions, please feel free to contact Coach Debra Skanes dskanes@miles.edu.
See you soon!
Sincerely,
Mrs. Debra Skanes
Miles College Head Cheerleading Coach
Please mail packets to:
Miles College
Attn: Mrs. Debra Skanes, Cheerleading Coach
Office of Admissions
P.O. Box 39800
Birmingham, AL 35208
Miles College
Try-Out Packet
Checklist
? $10 Try-Out Fee (nonrefundable)
? Must have an 2.0 or better GPA
? Admission Application (Miles College)
? Transcript
? ACT/SAT Scores
? Cheerleading Application
Cheerleading Waiver of Medical Liability
? Medical History and Examination Report (must have to tryout)
? Copy of Acceptance to Miles College (freshman and Transfers ONLY)
? 2 Letters of Recommendation (freshman and Transfers ONLY)
• 1 Letter from previous coach
• 1 Letter from individual of choice (excluding family members)
Cheerleading Try-Out Dates
Cheerleading Try-Outs:
If you can not attend please mail/email a video identifying yourself and your cheerleading skills:
Thursday August 18, 2011: Introduction/Overview 3:30-7:30
Friday August 19, 2011:
• Practice/workshop 3:30 PM-7:30 PM
Saturday April 20, 2011:
• Try-Out Day 10:00 AM - 3:00 PM
• For Try-Outs candidates will be REQUIRED to perform a cheer, chant, dance, stunts, jumps, and tumbling.
DRESS ATTIRE FOR TRY-OUT
Purple, White or Gray (no writing) (Exception; Miles College shirt)
Purple, Gold, Black Shorts
Biker shorts (black only)
Cheer shoes (lightweight, rubber soles)
White ankle socks
Thursday Purple Shorts White Shirt
Friday Black Shorts Gray Shirt
Saturday Gold Shorts Purple Shirt
**Please come dressed in the proper attire and be ready to work.
If selected for the 2011-2012 Miles College Cheerleading Squad, the following are upcoming payments.
Miles College
Cheerleading Application
Please Print
Full Name: _____________________________________ Student ID #: _____________________
Home Address: _____________________________________________________________________________
City: ____________________________________ State: _____________ Zip: ______________
Home Phone #: ___________________ Cell #: ____________________ E-mail:___________________
Email Address: _____________________________________________________________________________
Parents’ Name: (Mother) ________________________________ Occupation __________________________
(Father) ________________________________ Occupation __________________________
Year in college: ____________ Projected Graduation Date: _____________________ GPA: _____________
Major: __________________________________________
Activities you are involved with in college/high school: _____________________________________________
__________________________________________________________________________________________
Any honors/awards received in college/high school: _______________________________________________
__________________________________________________________________________________________
Birth date: ___________________________ Age: _____________ Ht: ____________ Wt: _____________ Sizes: Cheer Shoe: _______________ T-Shirt: ____________ Soffe Cheer Shorts: ____________
Emergency Contact Information:
Primary (Parent/Guardian) Secondary (optional)
Name(s) Name(s)
Address Address
__________________________________________ _______________________________________
Home Phone # Home Phone #
Work Phone # Work Phone #
Relationship Relationship
Miles College
Cheerleading Application
Skills Checklist
Check skills you have mastered (meaning you can do it 10 out of 10 times)
Tumbling
_____Standing back hand-spring
_____Standing back tuck
_____Standing back hand-spring back tuck
_____Toe touch back tuck
_____Round-off back hand-spring
_____Round-off back hand-spring back tuck
_____Round-off back hand-spring layout
_____Round-off back hand-spring full twist
Any tumbling skills you have that are not listed above: _____________________________________________
__________________________________________________________________________________________
Stunts
What is your primary stunting position? Base: ________ Flyer: _________ Spot: _________
Check the skills you have mastered (meaning you can do it 10 out of 10 times)
_____Straight up extension
_____Liberty
_____Arabesque
_____Heel Stretch
_____Bow & Arrow
_____Scale
_____Scorpion
_____Toe touch basket toss
_____Back tuck basket toss
_____Kick full or kick double basket toss
_____Full cradles
_____Double full cradles
Any stunting skills you have that are not listed above: ______________________________________________
__________________________________________________________________________________________
Cheerleading Background/Experience/Achievements: ___________________________________________
____________________________________________________________________________________________________________________________________________________________________________________
Cheerleading or Sports Related Injuries: ______________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________
Feel free to contact me with any questions: (205) 929-1655 or dskanes@miles.edu
Miles College
Cheerleading Waiver of Medical Liability
Date of birth________________
1. I, __________________________________will be participating in a walk on tryout with the cheerleading team. I presently have no injuries or illnesses that might prevent me from participating in the tryout.
Participant Signature_________________________________________Date________________
Parent/Guardian Signature
(If under18)____________________________________________Date__________________
2. In the event of an injury occurring during the tryout, I will not hold Miles College, Instructors, Directors, or the Cheer Coaches responsible in any way.
Participant Signature_________________________________________Date________________
Parent/Guardian Signature
(If under 18)___________________________________________Date________________
3. I have current medical insurance that will cover any costs incurred due to injury sustained during the tryout, camp and all other mandated activities.
Participant Signature_________________________________________Date________________
Parent/Guardian Signature
(If under 18)__________________________________________Date________________
Insurance Company: ____________________________________ Ins. Co. Phone #: _____________________
Policy #: ___________________________________ Group #: __________________________________
*Please provide a front and back copy of insurance card*
Please Read Carefully
By filling out and signing this application, you are stating that all the above information is true and correct. If chosen to be on the squad, as a MILES COLLEGE Cheerleader, you will be expected to give 100% participation at all times. It will be MANDATORY for ALL cheerleaders to attend camp and cheer at the men and women basketball games depending on what is ask of you by the coach. Also, if selected as a member of the MILES COLLEGE Cheerleading Squad, you will abide by this agreement in addition to the rules and regulations while at practice, try-outs, camps, games, as well as NCAA rules and the Miles College Cheerleading Manual.
Signature of Applicant: ______________________________ Date:______________________
Miles College
MEDICAL HISTORY AND EXAMINATION REPORT
Primary Sport:_______________________ Date of Physical:______________
Name: ______________________________ SSN: _______-________-________
Date of Birth: _______/________/________ Age: ________ College Year: 1 2 3 4 5
Student’s local address: __________________________ Name of Parent/Guardian: ______________________
_______________________________________________ Address: _____________________________________
_______________________________________________ ______________________________________________
Phone #: _______________________________________ Phone #: ______________________________________
Family Physician: (name)_________________________(city)__________________(phone#)_________________________
Emergency Contact: (name)_______________________(relationship)_________________(phone#)__________________
Physical Examination
Height: ________ Weight: _________ RHR (60sec): _________ BP:_________
Normal Abnormal Findings/Comments Initials
MUSCULOSKELETAL
Neck
Back
Shoulders/Upper Arms
Elbows/Forearms
Wrist/Hands
Hips/Thighs
Knees
Lower legs/Ankles
General Flexibility
Other Comments
MEDICAL
Eyes/Ears/Nose/Throat
Lymph Nodes
Heart
Lungs
Abdomen
Skin
Cleared: _____ NOT Cleared: ______ Cleared after completing eval./rehab for: ____________
Recommendations:______________________________________________________________________________________________________________________________________________________________________
Name of Physician:___________________ Signature of Physician: _____________________ Date:_________
I understand that this physical is for no other purpose than to clear me for athletic participation at Miles College. I understand that it is not a physical for illness that may develop in the future. I further agree that such illnesses will be taken to my personal doctor, or the athletic trainer for referral or care. I give authorization to the athletic trainer or team physician to evaluate and treat injuries that occur during my athletic participation at Miles College which includes first-aid treatment, X-Rays, physical exam, follow-up care, and rehabilitation. I understand the team physician has the authority to eliminate me from further participation because of an injury and/or because of undue risk to Miles College. No records will be released to anyone other than the team physician unless given my written approval. Athlete will not be able to participate in Miles College athletics until this form is completed and signed by athlete and team physician.
Signature: __________________________ Date: _____________________
Personal History
Circle “yes” or “no” for each of the following which may have occurred in the past 3 years. If you answer “yes” to any question, please clarify in the space provided.
Explanation/Comments
Have you had a medical illness since your last check-up or sports physical? YES NO
Have you been hospitalized? YES NO
Have you had surgery? YES NO
Are you currently taking any medications? YES NO
Do you have allergies? If yes, list medications.
YES NO
Do you have asthma? If yes, list medications.
YES NO
Have you had any severe asthma attacks? YES NO
Have you ever had racing of your heart or
skipped heart beats? YES NO
Have you had high blood pressure or high cholesterol? YES NO
Has a family member or relative died of heart problems or sudden death before the age 50? YES NO
Has a physician ever denied or restricted your participation in sports due to heart problems? YES NO
Have you ever felt dizzy or passed out during
or after exercise YES NO
Do you have a history of head injury or concussions? YES NO
Have you ever had a seizure? YES NO
Do you have frequent/severe headaches? YES NO
Have you had problems exercising in heat? YES NO
Do you have any problems with vision/eye? YES NO
Have you or family members ever been
diagnosed with sickle cell anemia? YES NO
Are you currently taking medication for
ADD/ADHD? YES NO
Please list any medication you are currently taking not listed above: __________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________
Have you ever broken or dislocated any joints? Pain in muscles or joints? Check all that apply:
Head: ____ Hip/Thigh: ____ Elbow: ____ Neck: ____ Knee: ____ Wrist/Hand/Finger: ____
Back: ____ Lower Leg: ____ Shoulder: ____ Chest: ____ Ankle/Foot: ____
Explanations:______________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
FEMALE ATHLETES ONLY:
When was your first menstrual period? __________________________________________________________________
When was your most recent menstrual period? ___________________________________________________________
What is the normal length of time between your periods? ___________________________________________________
I hereby state, to the best of my knowledge, my answers to the above questions are correct.
Athlete’s Signature: ______________________________ Date: _________
