cheerleader - yosef appearance request form

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CHEERLEADER - YOSEF APPEARANCE REQUEST FORM Requestor’s information: Name: _______________________________________ Title: ___________________________________ Email (for confirmation):_________________________________________________________________ Address: _____________________________________________________________________________ City: _____________________________ State: _______________________ Zip: ___________________

Event information: Organization/Company: _________________________________________________________________ Appearance date: ____________________ Time (start): ________________ (finish): ________________ Reason for Appearance: _________________________________________________________________ What part of the Spirit Program are you requesting? Include number of cheerleaders. *Additional cost will be added if number of cheerleaders exceeds four. Yosef _________ Cheer (#) ___________ Address of Appearance: _________________________________________________________________ City: ____________________________ State: _______________________ Zip: ____________________ Person to see upon arrival: _______________________________________________________________ On site telephone number: ___________________________ Estimated attendance: _______________________________ Special instructions for the appearance: ____________________________________________________ _____________________________________________________________________________________

I understand that the Appalachian State University Athletics Department is in no way liable for any injuries or damage sustained as a result of a member of the spirit team appearing at this event. The event must provide a place for changing on site and allow members to have a five to ten minute break for every two hours during the event. The undersigned agrees to assume any fees (including appearance and travel fees) that are incurred for the appearance. Signature of Requestor __________________________________________ Date __________________ TOTAL APPEARANCE FEE $ ___________