ATLEE RAIDERS CHEER Camp 2015 Rising 1 st -8 th graders REGISTRATION & APPAREL: Sign up for ALL Session I: June 23 Session II: June 24 Session III: June 25 2:00 – 4:00 PM three sessions by June 8 th and receive a FREE Camp T-Shirt. Registrations received June 9 or later can be purchased for $10. Late registrations and Walk-Ins are welcome, apparel can be ordered. Cheer Bow ($8) and Pom Poms ($7) are also available for purchase, must be ordered by June 12th. Mini Campers: Rising 1st-2nd grade Youth Campers: Rising 3rd-5th grade Junior Clinic: Rising 6th-8th grade QUESTIONS: Anne Melton, AHS Head Cheer Coach 804-723-2139 or [email protected] Atlee High School 9414 Atlee Station Road DEADLINE: must be received by June 17 th . Mail Follow camp signs to drop off Interested in cheering? Already cheer and want to improve your skills? Preparing for middle school Try Outs? AHS Cheer Clinic is the place for YOU! Cheering fundamentals taught by AHS Cheer Coaches and Cheerleaders: Motions, Jumps, Projection, Choreography & Stunting. Learn and Cheer, Chant, and Dance. or drop off completed Registration/Medical Release and Check payable to “AHS CHEER BOOSTERS”: c/o Dana Whittaker 9615 Cavalin Court Mechanicsville, VA 23116 **AHS Cheer Clinic is NOT affiliated with CMS Cheer Try Outs** COST: $20/session OR $55 for all three REGISTRATION (circle) Session I II III ALL Registration questions: [email protected] T-SHIRT SIZE (circle) Youth: S M L XL Adult: S M Cheerleader Name: _____________________________________________ Age: ______________ Grade for 2015-2016: ______________ Address: ________________________________________________________________________________________ Session Cost: ____________ + T-shirt (circle size): ______________ + Cheer Bow: _________ + Poms: __________ = TOTAL COST: $ ______________ MEDICAL RELEASE I certify that the named Cheerleader _______________________ is physically fit for conditioning and other related activities and has my permission to participate in the camp program. In case of an emergency, I understand that every attempt will be made to contact me. If contact is unsuccessful, I authorize the Atlee Cheer Camp Staff to perform immediate medical care, which includes but is not limited to the referral of the appropriate health care professionals, for any injury/illness that may occur while my child is participating in camp activities. Any expense incurred from such injury is the responsibility of the person signing below. I authorize the Atlee Cheer Camp Staff to provide any care or medical treatment as deemed necessary to my minor daughter/son. Please list below any medications currently being taken or any allergies and/or medical conditions that might restrict this individual from participating in any camp activities: ________________________________________________________________________. I understand that the Atlee Cheerleading Camp does not provide medical insurance and that my daughter/son is insured on a medical policy with: Insurance Co. Name: _______________________________________ Policy #: ________________________ Group #: ____________________________ PARENT SIGNATURE: _____________________________________________________________ DATE: _____________________
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