Tiny Tiger Cheer & Mascot Clinic
Tupelo Cheerleader’s
Tiny Tiger Cheer & Mascot Clinic December 14 & 15 That’s right, our cheer squads are holding a cheer clinic for boys and girls Kindergarten through 5th Mark your calendars!!! Children will be split into groups based on grade divisions. They will be taught a basic cheer, a chant, and a short dance. Each participant will receive a t-shirt. The Tiny Tigers will perform at half-time of the H.S. boys game on December 16 vs. Sasakwa. Time: 4:00 pm. – 6:00pm Where: High School Auditorium Cost: Pre-registered before Dec 9, 2016 is $20 per participant. **Families with 2 or more siblings participating will receive $5 off each registration. {NO REFUNDS} Late registration will be an additional $5 and participant may not receive t-shirt in time for performance. *** Please wear athletic shoes and clothing. Hair must be pulled back and off the shoulders. For safety purposes, no jewelry or gum is permitted. If you have any questions, please feel free to contact Dorothy Ray at [email protected] .
Tiny Tiger Cheer & Mascot Clinic Registration Form Please fill out this form completely and return to school with your payment in the amount of $25, no later than December 9, 2016 to guarantee a t-shirt. Please make checks payable to Tupelo Cheer.
PLEASE PRINT ALL INFORMATION: If you are registering more than one participant, please use separate registration forms. Participant’s Last Name: ____________________ First Name:_______________________ Age:____ Grade:____
siblings participating: __________________________________
Parent/Guardian Name(s): ____________________________________________________ Address:___________________________________________________________________ City:______________________________ State: _________ Zip: ______________________ E-mail:________________________ Home phone: _____________ Cell:_______________
Alternate Contact Information (in case of emergency and parent cannot be reached.) 1st Alternate Contact Person’s Name: ________________________ Cell: ______________ 2nd Alternate Contact Person’s Name: ________________________ Cell: ______________
T-shirt size (please circle child’s size): Youth: Adult:
sm(6-8)
md(10-12)
lg (14-16)
sm
md
lg
⃝ YES I would like my child’s picture taken with the Tupelo Cheerleaders. (I have included $5) Or an individual cheerleader:
Bryndee Kaya Kaitlyn Haylie Haven Addison Jaeley
⃝ NO I do not want my child to take a picture .
Tiny Tiger Cheer & Mascot Clinic Liability Waiver I understand that my child, _________________________________ will be participating in the Tupelo Tiny Tiger Cheer & Mascot Clinic on December 14 & 15. My child is in good physical shape and condition. Since this is a voluntary program, I will not hold the school, staff members, or cheer team members liable for any accidental injury, which could occur. In case of a medical emergency, I do give consent for my child to be treated at the nearest emergency room. Please list any allergies or health concerns we should be made aware of for your child, and any required special medications or treatments: ___________________ ______________________________________________________________________ Participant: ______________________ D.O.B.______________ Medical Insurance Carrier: ________________________________Policy Number: _________________ Parent/Guardian Signature: _______________________________________ Date: _______________________
₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮ For Office Use Only:
Payment
check # __________
cash ___________
Picture
YES
PD $5
T-Shirt
YS
NO YM
YL
AS
AM
AL
Tiny Tiger Cheer & Mascot Clinic December 14 & 15 That’s right, our cheer squads are holding a cheer clinic for boys and girls Kindergarten through 5th Mark your calendars!!! Children will be split into groups based on grade divisions. They will be taught a basic cheer, a chant, and a short dance. Each participant will receive a t-shirt. The Tiny Tigers will perform at half-time of the H.S. boys game on December 16 vs. Sasakwa. Time: 4:00 pm. – 6:00pm Where: High School Auditorium Cost: Pre-registered before Dec 9, 2016 is $20 per participant. **Families with 2 or more siblings participating will receive $5 off each registration. {NO REFUNDS} Late registration will be an additional $5 and participant may not receive t-shirt in time for performance. *** Please wear athletic shoes and clothing. Hair must be pulled back and off the shoulders. For safety purposes, no jewelry or gum is permitted. If you have any questions, please feel free to contact Dorothy Ray at [email protected] .
Tiny Tiger Cheer & Mascot Clinic Registration Form Please fill out this form completely and return to school with your payment in the amount of $25, no later than December 9, 2016 to guarantee a t-shirt. Please make checks payable to Tupelo Cheer.
PLEASE PRINT ALL INFORMATION: If you are registering more than one participant, please use separate registration forms. Participant’s Last Name: ____________________ First Name:_______________________ Age:____ Grade:____
siblings participating: __________________________________
Parent/Guardian Name(s): ____________________________________________________ Address:___________________________________________________________________ City:______________________________ State: _________ Zip: ______________________ E-mail:________________________ Home phone: _____________ Cell:_______________
Alternate Contact Information (in case of emergency and parent cannot be reached.) 1st Alternate Contact Person’s Name: ________________________ Cell: ______________ 2nd Alternate Contact Person’s Name: ________________________ Cell: ______________
T-shirt size (please circle child’s size): Youth: Adult:
sm(6-8)
md(10-12)
lg (14-16)
sm
md
lg
⃝ YES I would like my child’s picture taken with the Tupelo Cheerleaders. (I have included $5) Or an individual cheerleader:
Bryndee Kaya Kaitlyn Haylie Haven Addison Jaeley
⃝ NO I do not want my child to take a picture .
Tiny Tiger Cheer & Mascot Clinic Liability Waiver I understand that my child, _________________________________ will be participating in the Tupelo Tiny Tiger Cheer & Mascot Clinic on December 14 & 15. My child is in good physical shape and condition. Since this is a voluntary program, I will not hold the school, staff members, or cheer team members liable for any accidental injury, which could occur. In case of a medical emergency, I do give consent for my child to be treated at the nearest emergency room. Please list any allergies or health concerns we should be made aware of for your child, and any required special medications or treatments: ___________________ ______________________________________________________________________ Participant: ______________________ D.O.B.______________ Medical Insurance Carrier: ________________________________Policy Number: _________________ Parent/Guardian Signature: _______________________________________ Date: _______________________
₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮₮ For Office Use Only:
Payment
check # __________
cash ___________
Picture
YES
PD $5
T-Shirt
YS
NO YM
YL
AS
AM
AL
