West Holmes Mini Cheer Camp
West Holmes Mini Cheer Camp Hosted by West Holmes Cheerleaders Age 3 through grade 6 DATE & TIME: October 5th– 6:15-7:30 p.m. Registration begins at 5:45p.m. WHERE: West Holmes High School (commons) COST: $20—non-refundable WHY?: Great opportunity for an introduction to cheerleading or to improve cheerleading skills. Learn proper motions and technique, jumps, and cheers. Learn chants that will be performed at the Youth Night Football Game. Meet the High School Cheerleaders and enjoy fun games and activities. Registrations & payment received by September 22 will receive a Cheer T-Shirt. Performance for family and friends beginning at 7:30 p.m. on October 5. And you can see your child perform during the first quarter of the West Holmes Varsity Football Game on Friday, October 7. Camp will be taught by current West Holmes Cheerleaders and supervised by current program coaches.
To REGISTER: Please fill out registration form on the back and return to West Holmes High School on or before September 30 (Sept. 22 for a Cheer Shirt) with a payment of $20 per participant. You may Mail the form and check payable to:
West Holmes High School Attn: Raven Wilcox 10909 State Route 39 Millersburg, OH 44654
**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 Raven Wilcox at [email protected]. **Extra shirts will be ordered. If you miss the shirt deadline on the 22, the extras will go as first come first serve until we run out.
Mini Cheer Camp Hosted by the WHHS Cheerleaders
Registration Form Name: _____________________________________________________________________ Grade: ________ Phone: _________________________ Address: __________________________________________________________ Email: ___________________________________________________
Shirt Size: (Circle One) Youth: S M L XL or Adult: S M L XL Please return this completed and signed form to Attn: Raven Wilcox Cheerleading Coach; West Holmes High School, 10909 State Route 39, Millersburg, OH 44654. Please include your nonrefundable registration fee of $20 payable to West Holmes High School; Memo Mini Cheer Camp
West Holmes Mini Cheer Camp Medical and Liability Release: _____________________ elects to take part in the West Holmes Cheerleading event, which is sponsored by the West Holmes Cheerleading squad. I/We understand that our son/daughter is required to be in good physical shape and condition and that the activities, which he/she will be asked and expected to participate in may be strenuous and require physical and athletic agility. I/We understand that cheerleading is an activity in which the risk of injury exists; that any one of the routines involving our son/daughter’s participation in cheerleading activities in general could lead to injury. Despite this understanding of the possibility of injury, we still consent to the participation in this activity by our son/daughter. I/We represent to that, to the best of our knowledge and belief, our son/daughter has no physical, medical, or mental disability or other limitation that would restrict his/her ability to fully participate in this activity. I/We agree to, and by the signing of the agreement, release the coaches, volunteers, staff of West Holmes High School, and the Board of Education from any claim of negligence by ourselves or our son/daughter from any liability arising from claims for damages from injury to our son/daughter and any claims for loss or damage to his/her property which may arise out of his/her participation in the West Holmes Mini Cheer Camp on October 5 2016 I/We further acknowledge that the above individual is covered by health insurance, the particulars of which are described below. I hereby agree that we are responsible for any required medical treatment, and give permission for my child to receive medical treatment in the event that I am unable to be contacted. In order that the participant may receive necessary treatments, I hereby hold West Holmes High School and their Cheerleaders and coaches harmless in the exercise of this authority. Name of Participant: ______________________________________________________________________ D.O.B. __________________________ Address: _____________________________________________________________________________________________________________________ Parent Name: __________________________________ Phone: ________________________ Alternate Phone: ________________________ Medical Insurance Carrier: _________________________________________________________________________________________________ Address of Carrier: _________________________________________________________________ Policy Number: ______________________ Emergency Contact Name and Phone: _____________________________________________________________________________________ State any pre-existing conditions, allergies, medications, etc.: ___________________________________________________________ _________________________________________________________________________________________________________________________________
Parent/Guardian Signature: ______________________________________________________________ Date: ___________________________
To REGISTER: Please fill out registration form on the back and return to West Holmes High School on or before September 30 (Sept. 22 for a Cheer Shirt) with a payment of $20 per participant. You may Mail the form and check payable to:
West Holmes High School Attn: Raven Wilcox 10909 State Route 39 Millersburg, OH 44654
**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 Raven Wilcox at [email protected]. **Extra shirts will be ordered. If you miss the shirt deadline on the 22, the extras will go as first come first serve until we run out.
Mini Cheer Camp Hosted by the WHHS Cheerleaders
Registration Form Name: _____________________________________________________________________ Grade: ________ Phone: _________________________ Address: __________________________________________________________ Email: ___________________________________________________
Shirt Size: (Circle One) Youth: S M L XL or Adult: S M L XL Please return this completed and signed form to Attn: Raven Wilcox Cheerleading Coach; West Holmes High School, 10909 State Route 39, Millersburg, OH 44654. Please include your nonrefundable registration fee of $20 payable to West Holmes High School; Memo Mini Cheer Camp
West Holmes Mini Cheer Camp Medical and Liability Release: _____________________ elects to take part in the West Holmes Cheerleading event, which is sponsored by the West Holmes Cheerleading squad. I/We understand that our son/daughter is required to be in good physical shape and condition and that the activities, which he/she will be asked and expected to participate in may be strenuous and require physical and athletic agility. I/We understand that cheerleading is an activity in which the risk of injury exists; that any one of the routines involving our son/daughter’s participation in cheerleading activities in general could lead to injury. Despite this understanding of the possibility of injury, we still consent to the participation in this activity by our son/daughter. I/We represent to that, to the best of our knowledge and belief, our son/daughter has no physical, medical, or mental disability or other limitation that would restrict his/her ability to fully participate in this activity. I/We agree to, and by the signing of the agreement, release the coaches, volunteers, staff of West Holmes High School, and the Board of Education from any claim of negligence by ourselves or our son/daughter from any liability arising from claims for damages from injury to our son/daughter and any claims for loss or damage to his/her property which may arise out of his/her participation in the West Holmes Mini Cheer Camp on October 5 2016 I/We further acknowledge that the above individual is covered by health insurance, the particulars of which are described below. I hereby agree that we are responsible for any required medical treatment, and give permission for my child to receive medical treatment in the event that I am unable to be contacted. In order that the participant may receive necessary treatments, I hereby hold West Holmes High School and their Cheerleaders and coaches harmless in the exercise of this authority. Name of Participant: ______________________________________________________________________ D.O.B. __________________________ Address: _____________________________________________________________________________________________________________________ Parent Name: __________________________________ Phone: ________________________ Alternate Phone: ________________________ Medical Insurance Carrier: _________________________________________________________________________________________________ Address of Carrier: _________________________________________________________________ Policy Number: ______________________ Emergency Contact Name and Phone: _____________________________________________________________________________________ State any pre-existing conditions, allergies, medications, etc.: ___________________________________________________________ _________________________________________________________________________________________________________________________________
Parent/Guardian Signature: ______________________________________________________________ Date: ___________________________
