BURBANK CHEER TRYOUT PACKET 2021-2022
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BURBANK CHEER
TRYOUT PACKET 2021-2022
Parent Consent & Release Form & Guidelines for
2021-2022 School Year
Camp Commitment Form
Physical-Must be filled out by Doctor and uploaded
online
Instructions to upload physical online
Current Class Schedule
Tryout Flyer– Workshop dates & times-You keep
Name:_______________________________________________________
Grade for 2021-2022:_______________________
Current School:___________________________________________________
This packet is due to Ms. Burkhart no later than April 23rd 2021!!BURBANK HIGH SCHOOL CHEERLEADING TRYOUTS
Parent-Student Consent and Release Form
_______________________________________ ________________________ ____________________
Student Name Current School Grade Level (for next year)
TIME COMMITMENT: We understand that being a member of the Burbank High School Cheer Squad is a huge time
commitment. As members of the squad, students will be expected to:
Enroll and actively participate in 7th period Pep Squad
Maintain a good academic standing according to school policy
Actively participate in pep rallies, after-school practices, games, summer practices, summer camp, etc.
Cheer at games for football, boys/girls volleyball, boys/girls basketball, soccer, baseball, softball, water polo, etc.
**This is a yearlong commitment, if you choose to drop cheer or are removed by the Coach, it is considered
quitting the team. No donations will be returned to you and you WILL NOT be able to try out for any school years
following.
FINANCIAL COMMITMENT:
It costs $75,000 to run the cheerleading program for one year. This includes uniforms, camp, spirit attire, busses, and Homecoming
supplies. The team must acquire this amount through pledges, fundraisers, and donations. If our monetary goal is not met adjustments
will have to be made to the cheerleading program.
MAIN EVENTS:
Summer Cheer Camps
Summer Practices
Games (Football, Basketball, Volleyball, Baseball, Softball, etc.)
Seventh Period Cheer Class
After School Practices
All 3 Rallies (Fall, Winter, Spring)
Fundraising Events (selling masterdog cards, coaching at little kids cheer camp, selling snacks, magazine sales)
TRYOUT EXPECTATIONS:
You will be judged by professional cheerleading judges on the following:
1. Cheer – motions, arm angles, sharpness, precision, crowd encouragements
2. Appearance- proper attire each day
3. Dance – rhythm, timing, arm placement, footwork
4. Showmanship – spirit, confidence, audience appeal, enthusiasm
5. Jumps – flexibility, pointed toes, strong landing
6. Attitude/Motivation – willingness to learn and work with others
7. Grades – the higher the GPA, the better (10 week grades)
8. Teacher Recommendations – citizenship, work ethic, respect, following guidelines
9. Strength/Flexibility – pushups, cardio, splits
During tryouts, you should wear a mostly plain t-shirt, dark shorts, and gym shoes with your hair up and out of your face.
No jewelry, No gum.
I (parent’s name) ______________________________ hereby give consent for my daughter/son
(student’s name) _____________________________ to tryout for the Cheer Squad at Burbank High
School. We have read and understand the time commitment expectations and the costs of
cheerleading. We have read the tryout expectations and understand that ALL JUDGING IS FINAL
and all scores are confidential.
___________________________________________ ____________________
Parent Signature Date
____________________________________________ ____________________
Student Signature DateBurbank High School CHEERLEADING
Rules and Expectations 2021-2022
Coach Megan Burkhart – meganburkhart@burbankusd.org
Each cheerleader is expected to be a contributing member of the squad by being a positive role model, promoting school
spirit, and staying committed to the squad. You are representing Burbank High School Cheerleading and are expected to
act properly at all times, especially when you are at practices, games, school, and any time you are wearing any BHS
Cheer attire. This is a year long program and a year long commitment.
MAIN EVENTS:
Summer Cheer Camp
Summer Practices
Games (Football, Basketball, Volleyball, Baseball, Softball, etc.)
Seventh Period Cheer Class
After School Practice
Rallies
Fundraising Events (selling masterdog cards, coaching at kids cheer camp, car washes, snack sales, garage sales,
dinner nights, selling pancake breakfast tickets, selling Christmas trees, etc.)
A mandatory event may not be missed for any reason other than serious illness or an extreme family emergency.
Vacations, appointments, birthdays, work schedules, and being grounded are NOT valid reasons to miss a mandatory
event and will result in a lower grade in cheer class. Any absence lets down the entire squad since cheers and stunts
cannot be performed as previously practiced.
Every cheerleader will have to pass a football test in order to be cleared to cheer at football games. If she does not pass the
test, she will be benched from games until she is able to pass.
We MUST have a WRITTEN or EMAILED note from the parent, stating which practices over the summer will be
missed by May 27th, 2021. For every 3 unexcused practices that are missed over summer, you will be benched one full
football game in the fall.
CODE OF CONDUCT:
NO unacceptable language.
NO use of tobacco, alcoholic beverages, or drugs. This will result in consequences determined by the coaches
and may result in dismissal from the squad.
No inappropriate pictures on any social media site containing drugs, alcohol, illegal substances, or provocative
actions of any kind may result in dismissal from the squad.
You must treat the coaches and other cheerleaders with courtesy and respect at all times. Disrespect will result in
sitting out some or all of the practice or game.
You may not argue with the coaches. If you have a problem with a decision that is made, you may schedule a
meeting with the coach.
You must arrive to all practices/games/rallies/events on time and dressed in the appropriate attire.
NO food, drinks, cell phones, IPods, etc. at practices, games, or performances.
You must follow ALL teachers’ guidelines during class. Any cheating, disruptive behavior, or improper conduct
in ANY class will result in consequences in cheer.
If you are suspended from school for any reason, the coaches will determine the consequences that may result in
dismissal from the squad.
When any BHS cheer attire is worn in or out of school, each cheerleader is expected to carry herself like a classy
young lady.
No one other than squad members can wear cheer attire, including warm-up jackets.
Under no circumstances is any member of the squad allowed to write any negative comments about the coaches,
cheerleaders, or other schools on the internet, including Facebook, Twitter, etc. Negative comments will result in
consequences determined by the coaches such as being benched or, in severe cases, dismissal from the squad.
Varsity Squad – If any junior or sophomore on the varsity squad is not performing to the level expected, she can
be moved to the JV squad. If any senior is not performing to the level expected, she can be dismissed from the
squad. This is determined by coaches.
Final decisions of all disciplinary actions are at the discretion of the coach.GAMES:
Varsity, JV, and Freshmen squads cheer at games for almost ALL SPORTS:
• All home and away (JV and Varsity) football games; (freshmen only home games)
• All home boys/girls basketball games during season.
• Burbank vs. Burroughs game for all other boys/girls sports that do not conflict with a cheer event.
You must arrive at the gym/field/designated area dressed and ready to cheer 1 hour before the beginning of the game to stretch and
warm up stunts.
You will be benched a quarter at any games if:
• You do not arrive on time
• Arrive without the proper attire on
• Hair and makeup not done
• Having ANY jewelry on
• Having nail polish
You must be dressed properly for all games including wearing your uniform, cheer socks and shoes, hair up in a ponytail with a bow,
and not wearing jewelry or nail polish.
It is your responsibility to know what to wear and how to do your hair for dressing cheer casual or on game days. There will be
consequences if you are wearing the wrong attire.
It is your responsibility to keep your cheer clothes clean and in your possession. Do NOT put your uniform or camp clothes in the
dryer.
PRACTICES:
Practices will include stretching, conditioning (running, push-ups, sit-ups, etc.), stunting, arm motions, jumps, learning
cheers and dances, and some gymnastics. Having menstrual cramps is NOT a valid reason to not participate.
You must be dressed properly for all practices. This includes:
Black Shorts
P.E. shirt
Proper under support
Cheer shoes
Hair in pony tail
NO jewelry
Trimmed nails (No fake nails allowed)
Any of the above is not followed; you will lose all your participation points for the day.
GRADES:
Eligibility: A 2.0 grade point average is required on every 5-week grade report to be eligible to cheer.
First Offense – PROBATION – You will have weekly grade checks and suggested tutoring sessions.
Second Offense – INELIGIBLE – You will NOT be allowed to participate in any events after 3:00 pm including
practices, games, or other school events.
If you do not achieve a 2.0 by the third grading period, the coach reserves the right to dismiss you from the
program.
Seventh Period Cheer Class: Grades for sixth period cheer will be based on participation, wearing P.E. clothes, and
following all cheer rules and expectations. Grades for sixth period cheer will be based on a point system where each
cheerleader can earn 10 points a day.
Points will be subtracted from the available daily points for the following actions:
• Unexcused Absence = -10 points
• Non-suit = -10 points
• Disrespect = -10 points
• Tardy = -10 points
• Gum = -10 points
• Jewelry = -10 points• No ponytail = -10 points
• Not Participating = -10 points
• Using Cell Phone = -10 points
• Wrong attire/shoes/hair to School on cheer casual days= - 10points
Extras:
• Cheerleaders CAN NOT white card at any point during the year.
• There is to be no piercings during summer practices or the school year
• No fake nails. If a cheerleader decides to get nails, they will be removed from their stunt group until the nails
are removed.
• If a cheerleader does not abide by the rules and guidelines she will be put on probation (this is your warning)
second infraction is dismissal from the team. The parent will be contacted regarding probation.
Games: Grades for games will be based on participation, wearing correct attire, promoting school spirit, and following
all cheer rules and expectations. Grades for games will based on a point system where each cheerleader can earn 30
points per game.
Points will be subtracted from the available game points for the following actions:
• Unexcused Absence = -30 points
• Tardy = -10 points and benched a quarter
• Gum = -5 points
• Jewelry = -10 points and benched a quarter
• Hair not done upon arrival = -10 points and benched a quarter
• Eating during game (except half time) = -10 points
• Late to position after half time = -10 points and benched 3rd quarter
• Disrespect = -20 points and a phone call to parents
• Using Cell Phone (except half time) = -20 points
• Nail Polish = -10 points and benched a quarter or until polish is offCHEERLEADING GUIDELINES ACKNOWLEDGEMENT FORM
Ms. Burkhart
We have read, fully understand, and agree to abide by all parts of the 2021-2022 Cheerleading Rules and Expectations.
____________________________________
Student Name
____________________________________
Parent/Guardian Name
____________________________________ _____________
Student’s Signature Date
____________________________________ _____________
Parent/Guardian’s Signature Date
____________________________________
Student Email
____________________________________
Parent/Guardian EmailBHS CHEER CAMP – ALL SQUAD: Cheer Camp is “TYPICALLY” a 4-day, 3-night camp held in August at the JW Marriott in Palm Springs, CA taught by United Spirit Association cheerleading instructors. Camp includes coaching, USA cheer instructors, 4-day stay at Hotel, and 8 meals. The cheerleaders learn cheers, dances, stunt technique, how to cheer for offense versus defense, and other important cheerleading skills. Stunting is a very fun yet serious task. I cannot ensure that your son/daughter will be able to properly stunt without attending cheer camp. It is highly recommended that every cheerleader attends summer camp for these reasons. If a cheerleader does not attend, they will not be cleared to stunt for the first 15 weeks of school, this will include football games, rallies, appearances, field trips etc. Due to COVID we do not know what summer will look like. If we are able to hold a home camp where instructors come to us at BHS, I will let everyone know early on. Signing below just states that whichever type of camp we can hold in summer of 2021, you would like your student to participate. Cheerleader Name:______________________________________Grade level:________ Cheer Parent Name:__________________________________________ Cheer Parent’s Signature:__________________________________ Date:__________
Simi Burbank
Burbank
Valley
Burbank HighSchool
Unified
Unified
Unified School
School
School District
District
District
Athletic Emergency/Medical Information & Participation Form
PLEASE USE A BLACK OR BLUE BALL POINT PEN
Name (Student Athlete): Address:
City: State: Zip Code: Home Phone: ( ) Today's Date:
Grade: Age: Date of Birth: Sex: ID Number
Father's or Guardian Name: Employer: Phone: ( )
Mother's or Guardian Name: Employer: Phone: ( )
Emergency Phone: ( ) Family Physician: Phone: ( )
Health Insurance Provider: Policy # Does the insurance cover football? Y N
School attended previous semester: Place of Birth:
List all schools attended in the last 12 months: 1) 2) 3)
CHECK ALL SPORTS IN WHICH THIS STUDENT WILL PARTICIPATE IN:
FALL WINTER SPRING YEARLONG
❑ Football ❑ Girls Golf ❑ Soccer ❑ Softball ❑ Boys Golf ❑ Pep Squad ❑ Drama
❑ Cross Country ❑ Girls Volleyball ❑ Basketball ❑ Baseball ❑ Swim ❑ Dance Team ❑ IMA
❑ Girls Tennis ❑ Marching Band ❑ Wrestling
Girls Water Polo ❑ Boys Tennis ❑ Track ❑ VMA
❑ Boys Water Polo ❑ Boys Volleyball ❑ Powderpuff
Lacrosse
Medical History Questionnaire - This section must be completed by a parent or guardian. Name of Person Filling Out Form:
Yes No Yes No
1. Are you currently under a doctor's care for any reason? 15. Have you ever been dizzy or passed out due to the heat?
2. Have you ever been hospitalized? 16. Do you have trouble breathing after exercise?
3. Have you had surgery within the last 3 months? 17. Have you had any problems with your eyes or vision?
4. Are you currently taking any medications or pills? 18. Do you wear glasses or contacts or protective eyewear?
5. Do you have any known allergies (medicines, bee stings, etc.)? 19. Do you use any special equipment (splints, neck rolls, mouth guards, etc.)?
6. Have you ever been dizzy or fainted during or after exercise? 20. Has anyone in your family died of heart problems or sudden death before
the age of 50?
7. Have you ever had chest pains during or after exercise? 21. Do you have only one working organ of usually paired organs?
(eyes, kidneys, etc.)
8. Have you ever had high blood pressure? 22. Have you ever sprained, broken, dislocated, or had repeated swelling or
pain of any bones or joints?
9. Have you ever been told you have a heart murmur? 23. Have you ever had a stinger, burner or pinched nerve?
10. Have you ever had a racing heart or skipped heartbeats? 24. Have you had any medical problems or injuries? (asthma, mono, diabetes, etc.)
11. Have you ever had a head injury? 25. Have you had any medical problems or injuries since your last physical?
12. Have you ever been knocked unconscious? 26. Were there any special instructions or precautions given by the doctor?
13. Have you ever had a seizure? 27. When was the date of your last tetanus shot?
14. Are any of the following currently bothering you?
❑ Hand ❑ Wrist ❑ Elbow ❑ Forearm ❑ Hip ❑ Thigh ❑ Knee ❑ Ankle ❑ Shin/Calf ❑ Foot
Explain all "Yes" answers by question number. Indicate dates for each item and include any special instructions:
I/we hereby state, to the best of my/our knowledge, the answers to the questions for the medical history questionnaire above is true. I/we understand that by performing this examination,
the undersigned physician does not assume responsibility for medical care of this individual. I understand that this is only a pre-season screening and should in no way replace a
complete physical by your own doctor as recommended. I/we verify that I/we have read and understand all material presented and all information I/we have provided is correct
and I/we give permission for my/our child or ward to receive a physical exam and to participate in athletics.
In the event reasonable attempts to contact the parent/guardian at the above phone numbers meets with no success, full authorization is given for the administration of any treatment
Student Label Here
deemed necessary by a medical practitioner, and the transfer of son/daughter or ward to any medical practitioner, and the transfer of my/our son/daughter or ward to any licensed hospital
or emergency clinic reasonably accessible. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to
provide authority and power on the part of the school authorities and aforesaid agent(s) to give reasonable care. Facts are provided concerning the student athlete's medical history which
a medical practitioner should know.
Parent/Guardian Si g n a tu r e : Date:
Physician’s Report (to be filled out by Physician)
Date of last physical exam: Physician’s Stamp Here
Blood Pressure:
Height: Weight: Pulse Rate:
LIST ANY RESTRICTIONS THE ABOVE STUDENT MAY HAVE:
I hereby certify that the above named individual was examined by me on the above date and found physically fit to engage in interscholastic athletics.
Physician Si g n a tu r e : Date:Online Athletic Clearance
1. Visit www.AthleticClearance.com and choose your state.
2. Watch quick tutorial video
3. Register. PARENTS register with valid email username and
password. You will be asked to type in a code to verify you are
human. If this step is skipped your account will not activate. (If this
step is skipped, please contact us to activate your account)
4. Login using your email address that you registered with
5. Select “New Clearance” to start the process. PLEASE SELECT
BURBANK-SS.
6. Choose the School Year in which the student plans to participate.
Example: Football in Sept 2021 would be the 2021-2022 School
Year.
Choose the School at which the student attends and will compete
for.
Choose Sport
7. Complete all required fields for Student Information, Educational
History, Medical History and Signature Forms. (If you have gone
through the AthleticClearance.com process before, you will
select the Student and Parent/Guardian from the dropdown
menu on those pages)
8. Optional Donation to your athletic program or pay participation
fees (private schools only).
9. Once you reach the Confirmation Message you have completed
the process.
10. If you would like to register for additional sports/activities you may
check off those sports below the Confirmation Message.
Electronic signatures will be applied to the additional
sports/activities.
11. All of this data will be electronically filed with your school’s athletic
department for review. When the student has been cleared for
participation, an email notification will be sent.BURBANK HIGH CHEERLEADING TRYOUTS
CURRENT CLASS SCHEDULES
Part of the tryout process for BHS cheerleading, is to obtain teacher recommendations
from your CURRENT teachers. This process is done by Coach Burkhart before
workshops begin. Please fill out your current school and class schedule below so Ms.
Burkhart can contact your teachers. Thank you.
Student Name: ____________________________________ID#: _________________
Current School: _____________________________________
Class Name Teacher NameTRYOUTS
MUST TURN IN TRYOUT PACKET NO
LATER THAN APRIL 23rd
TO BHS CAMPUS or
Meganburkhart@burbankusd.org
WORKSHOPS:
MONDAY MAY 10TH 3:00-6:00 PM
TUESDAY MAY 11TH 3:00 -6:00 PM
WEDNESDAY MAY 12TH 3:00-6:00 PM
THURSDAY MAY 13TH 3:00-6:00 PM
FRIDAY MAY 14TH 3:00-6:00 PM
ACTUAL TRYOUTS SATURDAY MAY 15TH
Tryout Requirements:
Completed Tryout Application
Be cleared of all indebts to current school
Current 10-week GPA
CANNOT BE ON DANCE TEAM AND CHEER
KEEP THIS SHEET FOR YOUR INFORMATION!!
The Burbank Unified School District is committed to equal opportunity for all individuals in education. District programs and activities shall be
free from discrimination based on disability, gender, gender identity expression, genetic information, nationally, race or ethnicity,
religion, sexual orientation, or association with a person or group with one or more of these actual perceived characteristics.You can also read
