2019 Cheer Camp Registration Form

Please complete the below form to Register for our 2019 Cheerleading Camp.
Please note if completing the online registration form, please see the registration desk at the clinic to sign your waiver form.

Upon completion of this form you will have the option to prepay for the clinic below.
You are not obligated to pay with this option, you can pay by cash or money order in person at the clinic.

Cheer Camp Fee: $45.00
Convenience Fee: $1.50
Fee Includes: 5 1/2 Week Conditioning, Cheer Fundamentals 101 and/or Advance Techniques, Camp Gear & Completion Award Certification
Total Cost:$46.50

Date

Participant Information

First Name:

Middle Initial: Last Name:*

Phone Number:

Email Address:

Mailing Address:

City:

State:

Zip Code:

Birthdate:

Grade This August:

Age This August:

School Attending:

T-Shirt Size:

Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large

Parent/Guardian Information

Full Name:

Home Number:

Business Number:

Alternate Number:

Emergency Contact Name:

Emergency Contact Number:

My son or daughter has permission to attend the R.C.C. Fundamentals and Drills Camp.
I have no knowledge of any physical impairment that would affect or be affected by my son or daughter participation in the R.C.C. Camp program.
If any please indicate in the space provided below.

List any Physical Impairments
(if applicable):

In the event of any emergency in which my son or daughter required medical care. I authorize the staff of R.C.C. to act on my behalf and to obtain medical treatment to the R.C.C. Staff in its best judgment deems necessary and appropriate.
I specifically consent to such treatment including, but not limited to, hospitalization and surgery and will be responsible for any and all medical or other charges in connection with his/her attendance at camp.
I acknowledge that at R.C.C. Fundamentals and Drills Camp there is always a risk of an accident or injury. My son or daughter will participate in any activity that may include, but not limited to contact of the body with another person or objects, including the ground.
I specifically waive, give up and release The West Seven Rams Youth Club, R.C.C. Camp, its owners and staff from any and all liability from any and all claims for damages which I or my son/daughter may have for injuries or illnesses that he/she may sustain at camp.
I authorize R.C.C. Camp to use any photographs or articles about my son/daughter for publicity purposes.
I understand that violation of camp rules may result in my son/s or daughter/s dismissal from camp.

Would you like to be included in our mailing list?

Yes No

If yes, please provide your email address if different from the above:

Would you like to be sign up to received text message alerts? *

Yes

Mobile #:

Select if would like to prepay:

Prepayment