Super Cool Summer Camps 2015
Camper’s Name:___________________________________________ M/F:______ Age: ________D.O.B.:_____________________________
Parent Name:____________________________________________ E-Mail:_____________________________________________________
EMERGENCY Phone Number:_______________________________ 2nd EMERGENCY PHONE NUMBER:___________________________
*$20 Non-Refundable Deposit Per Camper Per Week Is Due At Time Of Registration*
____Mini Camp (Ages 3-5, T W Th, 9am-12:30pm, $65 /week)
*MUST BE POTTY TRAINED to participate.
____Half Day Camp (Ages 5 & Up, M - F, 9am-12:30pm, $95/week)
____Full Day Camp (Ages 5 & Up, M - F, 9am-4pm,$190/week) ____ Friday Only Camp HALF DAY (Ages 5 & Up, 9am-12:30pm)
$30/day
____ Friday Only Camp FULL DAY (Ages 5 & Up, 9am-4pm, $60/day)
All Dance Camps M – Th 9am-12pm $105/week
*List serious food allergies, physical limitations, and social or emotional concerns
that our staff should know
about:_________________________________________________________________________________________________________________
Theme
Dates
Mini Camp
Full
Day
M–F
9-4:00
Friday
Only
X
X
X
X
X
X
X
X
X
T,W & TH
9-12:30
DINOSAUR DIG
6/15-19
SO YOU THINK YOU CAN
DANCE *9am-12pm M-TH
6/22-26
ARTS & CRAFTS GALORE
7/ 06-10
LITTLE PRINCESS DANCE
7/13-17
CRAZY COOKING
7/20-24
CHEER DANCE
7/27-31
GAMES, GAMES, GAMES
8/03-07
*9am-12pm M-TH
*9am-12pm M-TH
NATURE’S DISCOVERY
Half
Day
M–F
9-12:30
Deposit Balance Balance Pd
Pd Date
Due
Date
H or F
ALL campers need to
bring a snack and water.
FULL DAY campers should
also bring a lunch.
NO NUT PRODUCTS
Campers should wear
comfortable gym clothes-no
buttons or zippers and long
hair must be tied back.
NO jewelry,
Campers will be
grouped based on skill & age.
If your child needs to be
grouped with a friend or
sibling, please make your
request BEFORE the first day
of camp.
PAYMENT & DISCOUNTS:
8/10-14
TEACH MY DOLLY TO
8/17-21
DANCE *9am-12pm M-TH
WHAT TO BRING & WEAR:
X
X
X
AUG 3rd thru 7th OPEN ENROLLMENT WEEK FOR FALL CLASSES ~ GET FIRST PICK OF YOUR
FAVORITE CLASS WITH YOUR FAVORITE INSTRUCTOR!
PERMISSION FOR MEDICAL TREATMENT AND RELEASE FORM: *I understand there are no refunds.
*Students are expected to carry their own accident/or medical insurance. The above named student(s) has had a medical
examination within the last twelve months and is capable of participating in the sport of gymnastics. *WARNING by the
very nature of the activity, gymnastics carries a risk of physical injury. By participating and/or giving my child permission to
participate in any Lake Norman Gymnastics Academy programs and/or classes, I acknowledge the fact that all programs
and/or classes offered at Lake Norman Gymnastics Academy involve a certain degree of risk to the participant. In the event
of an accident or illness I authorize any Lake Norman Gymnastics Academy employee to take the necessary steps regarding
emergency medical treatments, including first aid, calling of ambulance service or transportation to hospital. In my absence I
authorize the hospital facility and staff to treat my child for any illness or injury he/she has. I further understand that I am
solely responsible for costs incurred for any and all medical treatment. I fully understand the above and intending to be
legally bound do hereby, for my child, my heirs, executors and administrators, waive, release, discharge and indemnify any
and all rights and claims for damages, which may, or may thereafter accrue against Lake Norman Gymnastics Academy or
their respective officers, agents, successors and/or assigns for any injury or illness which may be sustained while
participating in classes or special events at any location. I have read the information for enrolling in programs and/or classes
at Lake Norman Gymnastics Academy and I understand the fees, rules and regulations listed for my benefit and I agree to all
terms and conditions. I acknowledge the fact that participation in any program at Lake Norman Gymnastics Academy
involves a certain degree of risk of serious injury, including paralysis or death. I voluntarily and knowingly recognize, accept
and assume the risk. I also understand that Lake Norman Gymnastics Academy has photographic rights and that throughout
enrollment photos and/or films may be taken and used for publicity purposes.
Parent/Guardian Signture_________________________________________Date _________________
Payment is due with
camp registration.
There is a $25 charge
for returned checks.
Register carefully; there
are NO REFUNDS.
Multi-week/sibling
discounts are available. A
student receives a 10%
discount on additional weeks
of camp if payment is received
at least 7 days in advanced
(does not apply to additional
days of camp).
Siblings attending same
camp receive 10% discount.
Only ONE discount may be
applied per camp.
Registrations received
less than 7 days in advance
are not eligible for any
discount.
704~483~1008
443 N Pilot Knob Rd
Denver, NC 28037
lkngymnastics.com