Permission to Participate & Informed Consent – Summer Camp I understand that my child, __________________ will be participating in summer camp at Virginia State University (“VSU”) on June 23-24, 2017. I acknowledge that I have read the information from VSU regarding the summer Woo Woo camp. I understand that my child will be participating in this summer camp with other students, non-members and volunteers from the VSU community. By signing this Consent Form and Release, I declare that I have legal custody and/or guardianship of _________________, a minor, and that I consent to allow _______________ to participate in the summer Woo Woo camp. Activities will include, but not be limited to: skills, basic fundamental drills, lecture and competition. I understand that participation in this activity is strictly voluntary. I have read, understand, and have discussed with my child that: A. Participants are expected to follow instructions of coaches, volunteers and other individuals that are overseeing the camp. B. Participants are expected to fully participate in activities outline by the adults/person in charge of events and activities, unless parent/guardian has made prior arrangements. C. Participants are expected to respect each other, equipment/ materials that are made available to them, and in charge of the event. I have discussed with my child the importance of following directions and safety procedures that will be outlined by the coaches and volunteers in charge of the activity. I understand that my child is not required to participate in this activity, but grant permission for him/her to do so, despite the possible risks. I understand that the personal information collected by VSU will not be disclosed to any third parties for any purpose. I recognize that by participating in this activity my child may risk personal injury. I hereby attest and verify that I have been advised of the potential risks, that I am fully knowledgeable of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of accident, illness, or other incapacity, regardless of whether I have authorized such expenses. Signed:___________________________Date:__________ (Parent/Guardian) Signed: ___________________________ Date:__________ (Participant)
Woo Woo Summer Camp Ages 6-17 (not open to high school graduates) Camp Cost: $75 Pre-Registration (t-shirt included) $100 Day of Camp (t-shirt included)
Cancellation and Refund No refunds will be given to campers who leave voluntarily or to those who are sent home for disciplinary reasons at the discretion of the camp directors. Camp Hours & Location June 23-24, 2017 from 9:00 a.m.-5:00 p.m. Multipurpose Center Camp registration/check in will begin at 8:00 a.m. What to Bring Participants are asked to bring a towel, snack. water bottle, and any other personal cheer attire. Contact Information Phone: (804) 524–6831 Fax: (804) 524–5763 E-Mail:
[email protected] [email protected] Payment Submit Checks or Money Orders to: VSU Athletics: 2017 Woo Woo Summer Camp P.O. Box 9058 Petersburg, Virginia 23806 or Call 804-524-5656 to pay by phone (Please submit application and payment together)
2017 SUMMER CAMP VSU WOO WOO June 23-24, 2017 Age: 6-17
CHEER CAMP FUNDAMENTALS This two day cheer camp focuses on individual development, teamwork and sportsmanship. Our staff will teach cheer fundamentals for beginners, provide a competitive environment for more advanced cheerleaders and give the skills and knowledge necessary to become a complete student or all around athlete. By combining skill development, cheers and dances with fun and high spirits, our camp ensures an enjoyable experience!
Date: June 23-24. 2017 Time: 9:00 a.m. - 5:00 p.m. Cost : $75 Pre-Registration (t-shirt included) $100 Day of Camp (t-shirt included) Age: 6-17 (not open to high school graduates)
Virginia State University invites you to become a part of what promises to be an enjoyable and exciting day with the Woo Woos!
2017 Woo Woo Summer Camp Application Please detach and return this competed form along with a check or money order made payable to “VSU Woo Woo Camp” Camper’s Name: ________________________ School:________________________________ Grade Entering Fall:_______ Age:__________ Primary Parent or Guardian Name: ______________________________________ Address:_______________________________ City/State/Zip:__________________________ Parent’s E-Mail Address:__________________ Parent’s Contact Number:__________________ In case of an emergency, if parent/ guardian cannot be reached please list contact person that can act on your behalf. Emergency Contact:______________________ Relationship:____________________________ (H)__________(C)___________(W)_________ Please list any medical condition or medication that camp staff should be aware of:___________ ________________________________________ ________________________________________