Rocky Point Cheerleaders

ANALYSIS OF THE EXTRA-CLASSROOM ACTIVITIES FUND FOR THE
ROCKY POINT NEW YORK SCHOOL DISTRICT CHEERLEADERS

Table of Contents

Introduction ................................................................................................................................................................ 2
Long Island Varsity Cheerleading Champion Club of Rocky Point (LIVCCC) ............................... 2
2012 National High School Cheerleading Championship (Medium Varsity Division II)
from the UCA .......................................................................................................................................................... 2
Events sponsored by the District .................................................................................................................. 3
Contributions from Campaign Contributions .......................................................................................... 4
Appointments and Compensation of Cheerleading Coaches .................................................................. 5
High School Varsity Coach................................................................................................................................ 5
High School Junior Varsity Coach .................................................................................................................. 5
Middle School Coach ........................................................................................................................................... 6
Appointments Pending Commissioner of Education Regulation Section 135.4 ........................ 7

Introduction

Kessler International (Kessler) was requested by concerned residents to look into
the finances for the cheerleading team which won the 2011 and 2012 National High School
Cheerleading Championship (Medium Varsity Division II) sponsored by the Universal
Cheerleaders Association (UCA). There was a concern about the whereabouts of the funds
contributed by the community and the expenses that were being incurred by the district.
The documentation cited in this report has been obtained through Freedom of Information
requests and through other publically available documents.

In their initial response to Kessler, Mr. Gregory Hilton, the School Business Official
of the Rocky Point School District (District) stated that the Long Island Varsity
Cheerleading Champion Club of Rocky Point is an independent club outside the jurisdiction
of the Rocky Point School District and that the District does not maintain any financial
records of the club. Yet Kessler found considerable expenses are being incurred by the
District in connection with the cheerleaders.

The New York State Education Department has in place protocols that mandate how
extra-classroom funds must be handled. According to their guidelines school districts in
New York State must provide for proper and adequate records of all receipts and
expenditures, and establish bank accounts for the deposit of such funds. Throughout the
course of our inquiry Rocky Point School District has not produced any relevant
documentation on its handling of funds for its Varsity Cheerleading club.

Long Island Varsity Cheerleading Champion Club of Rocky
Point (LIVCCC)

Kessler requested numerous documents from the District regarding the income and
expenditures of the cheerleading club -LIVCCC. The District responded and indicated that
all information pertaining to the request is held by the club itself, as LIVCCC is an
independent club outside the jurisdiction of the Rocky Point School District (Exhibit 1).

Kessler could not find that LIVCCC is listed as a corporate entity filed with the State
of New York or maintaining a Business Certificate in Suffolk County and no IRS Form 990
was filed as a tax exempt organization with the Internal Revenue Service. Although no
corporate entity has been registered, Kessler has determined that addresses associated to
LIVCCC is 544 Route 25A, Rocky Point, NY 11778, 6 Pigeon Road, Rocky Point, NY 11778
and 9 Old Orchid Court, Rocky Point, NY 11778.

2012 National High School Cheerleading Championship (Medium Varsity
Division II) from the UCA

The Rocky Point High School was awarded the 2011 and the 2012 National High
School Cheerleading Championship (Medium Varsity Division II) by the United Cheerleaders
Association (Exhibit 2).
2

The National High School Cheerleading Championship guidelines mandate that all
participants in the Medium Varsity Division II must be affiliated with a school district
(Exhibit 3). Furthermore, the Team Roster must be signed by both an Advisor and
principal of the school district they are representing as per the 2012 National High School
Cheerleading Championship registration form (Exhibit 4). A request was made to the
District for copies of all School Cheer Team Eligibility Rosters certified or signed by a
principal or school district employee, the District responded No such document exists
within the District. If the roster of players was not legitimately authorized by the District,
the status of the team eligibility could be questioned.

Events sponsored by the District

A Rocky Point Cheerleading/Stunt Clinic flyer observed on the District website
(http://www.rockypointschools.org/pdf/nationalcheer.pdf), indicates that on April 2,

2011,
a cheerleading/stunt clinic was held for all girls grades K 8 at the Joseph A. Edgar Gym at
525 Route 25A, Rocky Point. Furthermore the flyer states the following (Exhibit 5):

All campers will be instructed by Rocky Point J.V. and Varsity cheerleaders. They will be
taught the fundamentals of cheerleading along with assorted cheers, chants and dances.
The stunt clinic will focus on the proper techniques of stunting.

Come and see our very own UCA National Varsity Cheerleading Champions
See the routine that brought the national title home to Long Island!

If you are interested, please detach and fill out the form below.
Include your check for $20/$25 made out to LIVCCC and bring with you or send to:
RP Cheer 6 Pigeon Road Rocky Point, NY 11778

If you prefer, place payment and slip in an envelope marked Cheer Clinic and have you child
return it to her teacher by Wednesday, March 30
th

Any questions Contact Janet @ 255-6636

Although the District has stated that LIVCCC is an independent club outside the
jurisdiction of the Rocky Point School District, they appear to be collecting payments for a
private cheerleading/stunt clinic.

Similar postings were found for the current school year for both grades K thru 6
th

for the high school. (Exhibit 6)

Kessler requested copies of the Applications for Use of School Facilities for the
District. A total of 34 applications were provided between June 25, 2008 and March 28,
2012 (Exhibit 7) applicable to cheerleading activities. The activities described in the
applications of Rocky Point Cheer or LIVCCC include:

Seasons Daily Practice
Fundraising
UCA Camp
Tryouts
3

Clinics
Competitions

Although the applications have a specific section indicating the fee charged for the
usage of the Schools facility, no payments were collected for LIVCCC.

The only facility use fees collected during 2008 through 2011 were from the
following (Exhibit 8):

Rocky Point Owners, Inc.
Rocky Point Touchdown
Rocky Point Lions
Boy Scouts of America
Rocky Point Booster Club
Ticket to Broadway
CYO
North Shore Youth Council

Contributions from Campaign Contributions

LIVCCC received at least $2,500.00 in contributions from various political
campaigns from 2009 through 2013 (Exhibit 9). The address listed for LIVCCC is stated as
544 Route 25A, Rocky Point, NY 11778 and 9 Old Orchid Court, Rocky Point, NY 11778. We
also found contributions totaling $300.00 given to Rocky Point Cheerleaders Club, 82 Rocky
Point Yaphank Road, Rocky Point, NY and $100.00 given to the Long Island Varsity
Cheerleading Club, 544 Route 25A, Rocky Point, NY. The District had no record of any
receipt of these contributions.
.

4

Appointments and Compensation of Cheerleading Coaches

High School Varsity Coach

The High School Varsity Coach (HSVC) was appointed by the District for school
years 2008/09 through 2011/12. As per the Rocky Point School District Notice of
Appointments, The individual was compensated as the Varsity Cheerleading Coach from
2008/09 through 2011/12 in the amount of $43,249.

The Notice of Appointments for HSVC was provided by the district indicates that
contracts are on an annual basis, yet we found the individual was contracted in 2008/09,
2010/11 and 2011/12 twice annually each year for the same position. It is unclear if these
appointments are duplicative.

Table 1
High School Varsity Coach Notice of Appointments
School
Year
Position Salary
2008/2009 Varsity Cheerleading Coach, HS $ 5,737.00
2008/2009 Varsity Cheerleading Coach, MS 6,236.00
2009/2010 Varsity Cheerleading Coach, HS 6,236.00
2010/2011 Varsity Cheerleading Coach, DW 6,521.00
Total $ 43,249.00

High School Junior Varsity Coach

The High School Junior Varsity Coach (HSJVC) was appointed for school years
2008/09 through 2010/11. As per the District Notice of Appointments the HSJVC was
compensated as the coach in the amount of $21,267 plus a per hour basis for the position of
Intramural Advisor (2009/10) and Intramural Athletics (2010/11) at $23/hour and
Chaperone (2010/11) at up to 2 hrs. $52; over 2 hours $78; Jr. Prom/ Sr. Prom $52 hour.
The Notice of Appointments for the HSJVC indicates that contracts are on an annual basis,
yet Kessler found the HSJVC was contracted in 2008/09 and 2009/10 for two appointments
of JV Cheerleading Coach in each year.

5

Table 3
High School Junior Varsity Coach Notice of Appointments
School
Year
Position Salary
2008/2009 JV Cheerleading Coach, HS $ 4,116.00
2008/2009 JV Cheerleading Coach, HS 4,615.00
2009/2010 Intramural Advisor, DW $23/ Hour
2010/2011 Intramural Athletics, DW $23/ Hour
2010/2011 Chaperone, DW
up to 2 hrs. $52; over 2
hrs. $78; Jr. Prom/Sr.
Prom $52 hour
Total $ 21,267.00

Middle School Coach

During the school year of 2008/09 through 2011/12 the Middle School Coach
(MSC) was granted the position of Middle School Cheerleading Coach as per the District
Notice of Appointments. The District Notice of Appointments during this period total salary
of $32,656.

Table 5
Middle School Coach Cheerleading Notice of
Appointments
School
Year
Position Salary
2008/2009 Cheerleading Coach, MS $ 3,492.00
2008/2009 Cheerleading Coach, MS 4,490.00
2010/2011 MS Cheerleading Coach, DW 4,695.00
Total $ 32,656.00

The Notice of Appointment documents indicate that the appointments for Middle
School Cheerleading Coach are on an annual basis, yet we found the position of Middle
School Cheerleading Coach twice in each year (2008/09, 2009/10, 2010/11 and 2011/12)
at different pay rates. The salary paid for the Middle School Cheerleading Coach ranged
from $3,492 in 2008/09 to $4,695 in 2011/12.

6

In addition to being a Middle School Cheerleading Coach, this individual was also
assigned to the following positions at a total salary of $9,770.00:

Table 6
Other Notice of Appointments
School
Year
Position Salary
2009/2010
Production Manager
(Musical), MS
$ 1,946.00
2010/2011 Director (Musical), MS 2,608.00
2010/2011 Set Painting (Musical), MS 1,304.00
2011/2012 Director of Dramatics, MS 2,608.00
2011/2012 Set Painting, MS 1,304.00
Total $ 9,770.00

Appointments Pending Commissioner of Education Regulation Section 135.4

The Notice of Appointment dated November 18, 2009 for three coaches references
that the position is pending revised Commissioner of Education Regulation Section 135.4
requirements for PE (7/16/09). It is unclear if the requirements were satisfied, as no
documentation was provided by the District to indicate that these coaching qualifications
have been obtained.

7

EXHIBIT 1
ROCKY POINT UNION FREE SCHOOL DISTRICJ'
BUSINESS OFFICE
90 Rocky Point - Yaphank Road
Rocky Point, New York 11778
1etephone: (631) 744-1600 Fax: (631) 849-7556
Dr. Michael F. Ring
Superintendent of Schools
November 17. 2011
Michael G. Kessler
Re: FOIL Request #12-16
Dear Mr. Kessler:
Gregory Hilton
School Business Official
ln response to your Freedom of Information Law request, the Long Island Varsity Chccrleading
Champion Club of Rocky Point (LIVCCC) is an independent club and outside the jurisdiction of the
Rocky Point School District. All information pertaining to your request is held by the club itself;
therefore, no requested docmnents exist within the School District.
Gr ii ton
School Business Official
/L d
9SSL.6?9L9
9SSL.619L9 ;s:eL 22LL-LL02
EXHIBIT 2
Results
2012 National High School Cheerleading Championship
Medium Varsity Division II
Final Results
1 Rocky Point High School
2 Clay County High School
3 Live Oak High School
4 Pinelands Regional High School
5 Delaware Valley Regional High School
6 St Catharine Academy
7 University School of Jackson
8 Bishop McCort Catholic High School
9 Ouachita Parish High School
10 Richland High School
11 Christian Academy
12 Clearfield High School
13 LaRue County High School
Finalist
Bishop Mccort Catholic High School
Christian Academy
Clay County High School
Clearfield High School
Delaware Valley Regional High School
LaRue County High School
Live Oak High School
Ouachita Parish High School
Pinelands Regional High School
Richland High School
Rocky Point High School
St Catharine Academy
University School of Jackson
Advancing Straight to Finals
Semi-Finals Group A
lmmaculata High School
Lexington Catholic High School
Masuk High School
Purvis High School
Vernon Township High School
Prelims Group A
Sacred Heart Academy
lmmaculata High School
Eisenhower High School
Bibb County High School
Masuk High School
Vernon Township High School
Purvis High School
St John Villa Academy
St Georges School
Hernando High School
Lexington Catholic High School
Semi-Finals Group B
Archbishop Carroll High School
Christian Academy
Marple-Newtown High School
University School of Jackson
Prelims Group B
Columbia High School
Archbishop Carroll School
Christian Academy
Penns Manor High School
Marple-Newtown High School
Universal School of Jackson
West Morris Mendham High School
Amory High School
Ponderosa High School
Prairie High School
VARSITY.COM
EXHIBIT 3
UCA
2012 - 2013 School and Youth I Rec
NHSCC Divisions Only
JUNIOR HIGH I JUNIOR VARSITY DIVISIONS
Small Junior High 9th grade and below Female/Male 5 - 16 Members
Large Junior High 9th grade and below Female/Male 17 - 25 Members
Small Junior Varsity 12th grade and below Female 5 - 16 Members
Large Junior Varsity 12th grade and below Female 17 - 25 Members
Junior Varsity Coed 12th grade and below Female/Male 5 - 25 Members
VA RS ITV
Note: Official Junior Varsity Team or a
JH team with a majority of 9th grade
team members.
team members.
team members.
Junior High Division Guidelines: Junior High teams may include 9th grade participants IF (1) the school represented includes a 9th grade class AND (2) a minority of
the team are 9th graders. Junior High teams with a majority of 9th grade participants must compete as a Junior Varsity.
VARSITY DIVISIONS
To create a Championship that gives equal opportunity for schools of similar student composition, UCA will sub-divide the below listed divisions at the NHSCC based on
school enrollments in the 9th - 12th grades as of October 1, 2011. Check out www. uca. varsity. com for more details.
Small Varsity Division I 12th grade and below Female 5 - 12 Members 1300 and above
Small Varsity Division II 12th grade and below Female 5 - 12 Members 1-1299 Students
Medium Varsity Division I
Medium Varsity Division II
Large Varsity Division I
Large Varsity Division II
Super Varsity Division I
Super Varsity Division II
Small Varsity Coed Division I
Small Varsity Coed Division II
Large Varsity Coed
Super Varsity Coed
Non Building Divisions
Junior Non Building
Small Varsity Non Building
Large Varsity Non Building
Non Tumbling Divisions
12th grade and below
Female
Female
Female
Female
Female
Female
Female/1-4 Males
Female/1-4 Males
Female/5 + Males
Female/1 +Males
13-16 Members
13 - 16 Members
17 - 20 Members
17 - 20 Members
21 - 30 Members
21 - 30 Members
5 - 20 Members
5 - 20 Members
5 - 20 Members
21 - 30 Members
Non Building Divisions: No partner stunts, pyramids or tosses allowed.
JR or JV team Female/Male 5 - 30 Members
12th grade and below Female/Male 5 - 15 Members
12th grade and below Female/Male 16 - 30 Members
1300 and above
1-1299 Students
1600 and above
1-1599 Students
1600 and above
1-1599 Students
1600 and above
1-1599 Students
Note: 5 or more males allowed.
Note 1 or more males allowed
NEW - The Non- Tumbling division will prohibit all tumbling with feet over head rotation. Legal inversions into or from stunts will not be considered
tumbling and are allowed in this division.
Junior High Non Tumbling 9th grade and below Female/Male 5 - 25 Members
Junior Varsity Non Tumbling
Small Varsity Non Tumbling
Medium Varsity Non Tumbling
Large Varsity Non Tumbling
Female/Male 5 - 25 Members
Female I 0-2 Males 5 - 12 Members
Note: Up to 2 males allowed.
Junior High Non Tumbling Age Guidelines: Junior High teams may include 9th grade participants IF (1) the school represented includes a 9th grade class AND (2) a
minority of the team are 9th graders. Junior High teams with a majority of 9th grade participants must compete as a Junior Varsity.
YOUTH I RECREATIONAL DIVISIONS
'The following d1v1s1ons will follow standard safety gwdelmes
The youth recreational division exists for teams with the main purpose of cheering for and supporting a recreational team (i.e. youth football, pee wee sports, community
sports teams, etc.) Competitive only youth programs are considered an all star program, and must compete as an all star team and follow the all star rules and
regulations. Teams with a school affiliation may compete in the youth recreational division, only if at least half of the participants are in the 6th grade or younger Teams
with a school affiliation that have a majority of 7th and Bth graders must compete in the junior high division.
Pee Wee Rec
Youth Rec
Junior Rec
Senior Rec
7 yrs and younger
9 yrs and younger
12 yrs and younger
14 yrs and younger
Note: The age of the competitor as of August 1. 2012 will be the age used for the competition purposes throughout the
2012-2013 season for all Youth I Rec Divisions.
EXHIBIT 4
2012 TRAVEL PACKAGE
HIGHLIGHTS:
* 3 DR 4 DAY WALT DISNEY WORLD
PARK-HOPPER PASS
Unlimited admission for three or four days to the *Magic Kingdom Park, Disney's
Hollywood Studios, Epcot and Disney's Animal Kingdom Theme Park.
3 Days premium admission into ESPN Wide World of Sports
Complex (both the HP Field House and Jostens Center) .
* P ~ C i ~ "UCA NIGHT" AT THE
MAGIC KINGDOM PARK!
* PRIVATE CHAMPIONSHIP
CELEBRATION PARTY!
To be held Sunday evening at the Disney's Hollywood Studios
complete with thrilling rides and a DJ
*WALT DISNEY WORLD COUNTER SERVIC
MEAL VOUCHERS
Lunch or Dinner ONLY. Check your voucher for participating establishments.
* AIRPORT TRANSFERS WITH DISNEY'S
MAGICAL EXPRESS
Round trip airport transfers provided to and from Orlando International
Airport ONLY!
* Bus TRANSPORTATION TD ALL
SCHEDULED EVENTS
* ALL TAXES AND GRATUITIES
HOTEL AND TRAVEL
1. What is the advantage of purchasing the travel package?
It is not required that you attend the NHSCC on the travel package.
The two main reasons teams purchase the package are convenience and savings.
a)Convenience - Everything is handled for you. Disney's Magical Express will pick you up and take you back
to the airport. There is no hassle of renting vans or cars and finding drivers. Hotel registration is smoother and
rooms are guaranteed. The NHSCC office works together with the Walt Disney World Resort to block your
rooms so your entire group stays together.
If you book your own trip, you have to:
Step 1 : Call travel Agency or airlines (which could take hours).
Step 2: Send in deposit for airline tickets.
Step 3: Call several hotels to get room rates and availability.
Step 4: Guarantee all rooms using personal credit card for deposit.
Step 5: Request reimbursement check from the school.
Step 6: Send your rooming list to the hotel.
Step 7: Call car rental agencies to find out rates and regulations of drivers.
Step 8: Fill out registration form for the NHSCC and mail in with registration fees.
If you book with NHSCC you have to:
Step 1 : Call Travelfocus or your local travel agent to book flights.
Step 2: Send in deposits for airline tickets.
Step 3: ~ l l out registration forms for the NHSCC and mail in deposits.
b) Savings- Because of our longtime relationship with the Walt Disney World Resort, the NHSCC is able to
negotiate discounted rates for hotel rooms and theme park tickets.
2. What hotel are we staying in?
Accommodations will be provided at Disney's All Star Resorts and Disney's Caribbean Beach Resort. Your team
may choose which resort they would like to be housed in. Disney's All Star Resort is a very nice yet economical
hotel. Disney's Caribbean Beach Resort is a more upscale hotel on the Walt Disney World property. Therefore
the main difference in package prices is the hotel cost only. All other services will remain the same for both ho-
tels. In the event that the Walt Disney World Resorts sell out of rooms, NHSCC will make arrangements with
an alternate hotel off property. PLEASE NOTE: Hotels may fill up prior to posted deadlines and may include ad-
ditional costs.
3. We have parents who would like to come to the Championship. Can they sign up for the
NHSCC travel package?
Of course! A lot of coaches meet with the parents and include them on the travel package with their team.
However, we encourage family members and friends to register- with us directly. For the Family and Friends reg-
istration form, see pages 27-30.
4. We have an uneven number of girls. Can we pay the quad rate for three girls in a room?
No. The travel package prices have been calculated according to how many people are in each room.
5. Can we have five people in a room?
No. The All Star Resorts and Caribbean Beach Resort do not allow more than four people to a room.
6. We are arriving in Orlando at 10:00 a.m. on Friday, will our hotel rooms be ready?
Most hotels do not guarantee check in until 4:00 p.m. However, if there are rooms ready in your block, the hotel
. will check you in early. Please be sure to communicate this to your entire group that is traveling with you.
7. Our team doesn't leave Orlando until 6:00 p.m. on Tuesday. What can we do all day?
Hotel check out is at 11 :00 a.m. If you would like, you can take a Walt Disney World Resort shuttle bus to
Downtown Disney-West Side to shop or to one of the Walt Disney World Theme Parks. The hotel will be glad
to store your luggage for you, but you will be responsible for picking them up before you depart.
8. How do I request a refund?
All cancellations must be in writing to the Championship. We will not accept cancellations by phone. Deposits from
cancellations cannot be applied toward your balance.
TICKETS AND COMPETITION
1. When will we receive our Walt Disney World Theme Park tickets
for the Championship?
You receive your tickets when you register with NHSCC at your hotel in Orlando.
2. Do we use our 3 or 4 day PARK HOPPER ticket for competition?
Yes. You will need a Walt Disney World ticket to enter Disney's Hollywood Studios TM as well as the ESPN
Wide World of Sports Complex for competition. Admission to ESPN Wide World of Sports Complex is
NOT considered a theme park admission, and therefore does not use a day on your Park Hopper.
3. What does "PARK HOPPER" mean?
A PARK HOPPER allows you to go from Theme Park to Theme Park. Example: you can use your PARK HOPPER
ticket to enter Disney's Hollywood Studios TM for Competition Saturday morning and then go to Epcot that
evening, and it is only considered one day of admission. However, these tickets are only valid for four days.
4. Will attending the UCA parties take days off of my PARK HOPPER pass?
For the Special "UCA NIGHT" at Magic Kingdon Park, a day of admission will be taken off your PARK
HOPPER pass regardless of what time you arrive. For the Championship Celebration Party at Disney's Holly-
wood Studios, a day will not be taken off of your PARK HOPPER pass. Please Note: YOU MUST HAVE A
WRISTBAND TO ATIEND ALL PARTIES.
5. If we do not use all four days of our Walt Disney World tickets, may we use
them next year?
No. All of the discounted tickets sold at the NHSCC have an expiration date that is listed on the
back of your ticket.
6. Do spectators have to purchase a Walt Disney World PARK HOPPER ticket in order to watch
competition at the ESPN Wide World of Sports Complex?
No! If you are only going to the ESPN Wide World of Sports Complex, you may purchase a ticket at the door
for $25 per day per person. However, if you purchase a Walt Disney World PARK HOPPER ticket from the
NHSCC it includes admission into the ESPN Wide World of Sports Complex.
7. Are there discounted park tickets available for family and friends not on the
travel package?
Yes, there are two different tickets.
1) 5-day PARK HOPPER Ticket- $256.00
Order Forms for these tickets can be found on page 12. Walt Disney World PARK HOPPER tickets are valid
for unlimited admission into the Magic Kingdom, Epcot, Disney's Hollywood Studios, and Disney's
Animal Kingdom Theme Park as well as three days of admission into ESPN Wide World of Sports
Complex. These tickets DO NOT include NHSCC bus transportation to the parks.
8. How do I find out when and where my team competes?
A detailed order of competition will be posted at uca.varsity.com in mid January. The detailed order of
competition will tell you the location and exact times that your team will report backstage, take pictures,
warm up, and compete. uca.varsity.com
HOW TD REGISTER
Registration can be easy! Follow our helpful steps below and you are sure to have a successful, stress free registration.
If you need assistance in any way please contact our National Office at 1-888-243-3782.
SCHOOL AND YOUTH RECREATIONAL TEAMS
Step 1- To get started, find and fill out the forms listed below
- Team Registration Form Pg 7
- Accommodations Page Pg 9
- Rooming List Pg 10
If your qualifying competition takes place in October or November, this
packet and deposit are due December 2, 2012.
- Team Roster Pg 14
If your qualifying competition takes place in December, this packet and
deposit are due December 2, 2012.
- Rules & Regulations Pg 18-24 HOTELS MAY FILL UP PRIOR TO PUBLISHED DEADLINES.
Step 2- Have a Parent Meeting!
- Hove ALL Parents sign the Cancellation Policy for their participant.
- Cancellation Policy Pg 12
- Parents (or school) pays $100 per person Non Refundable Deposit.
- $1 00 per person Non Refundable Deposit
- Inform your parents about how they con toke advantage of our travel package.
*****See the bottom of this page for more details!!!!*****
Step 3- Send off your Initial Registration to NHSCC, P.O. Box 752790, Memphis, TN 38175 or
6745 Lenox Center Court, Suite 300, Memphis, TN 38115
The following items should be included in your initial registration:
____ Registration Form Accommodations Page ____ Rooming List
____ $100 Per Person Deposit Signed Cancellation Policy
____ Signed Copy of Rules and Regulations
Step 4- DUE BY January 5th! Fill out and collect the following:
____ Balance of Payment Music Information Sheets _ _ _ _ Team Roster
____ Medical Release Forms . Safety Video
(These will be included in your return pocket ofter you register.)
ALL FORMS IN STEP 4 AND BALANCE OF PAYMENT ARE DUE BY January STH
*** FRIENDS AND FAMILY REGISTRATION INFORMATION ***
UCA encourages friends and family to attend our Notional Championship! We wont to offer them the some great packages
that teams ore offered. We HIGHLY encourage friends and family to set up their own registration separate from the team. This
will allow your parents and friends to pick up their own registration pocket and tickets in Orlando! Friends and Family registration
is very easy!
ADVISORS/COACHES- Turn to page 24. Here you will find the Friends and Family registration form. Instead of ~ toking core
of all of the parents reservations, now they con do it themselves! You con tear out the forms on Page 27-30, make copies, and hand
it out at your parent meeting. Parents will fill out their own information and moil it bock to UCA themselves!!! There is a Credit Cord
Payment Form conveniently located on the bock of the Friends and Family registration form. Parents, grandparents, and friends alike
con all use this to purchase our travel package.
NEW! On-line Registration is Now Available on uca.varsity.com.
REGISTRATION FORM
2012 NATIONAL HIGH SCHOOL CHEERLEADING CHAMPIONSHIP
THIS FORM IS DUE EVEN IF YOU ARE NOT ATTENDING ON THE NHSCC TRAVEL PACKAGE.
NEW! On-line Registration is also available on uca.varsity.com.
PLEASE COMPLETE IN BOTH ADDRESSES (PRINT OR TYPE IN BLUE OR BLACK INK)
0 PLEASE SEND INFO TD DUR SCHOOL ADDRESS BELOW:
School/Teem Nome
Conlocl Person
School/Teem Address
City, S101e, Zip
School Phone School Fox
Qualifying Compelilion Dole
0 PLEASE SEND INFO TD THE HOME ADDRESS BELOW:
Person to Receive Information
Home Address
Home Ci ty, Slole, Zip
I I I
Work Phone Home Phone Cell Phone
E-mail Address
LIST YUUR FEDEX SHIPPING ADDRESS BELOW
(ND P.O. BOXES, PLEASE):
Street Address
City/State/Zip
Daytime Phone Email Address
( )
Cell Phone
PLEASE COMPLETE ONLY IF YUU ARE NOT PURCHASING
THE NHSCC TRAVEL PACKAGE!
0 Our team will NOT be attending on the NHSCC travel package. We will be
making our own arrangements. Listed below is information regarding
where we will be staying in Orlando, including a phone number.
Ho1el Nome
Nome Registered Under
Holel Address
2012
Holel Phone Dole of Check-in
Advisor's Signolure
N<
PLASE CHCK ONE;
YOUTH/REC DIVISIONS
0 Pee Wee Recreational
7 yems & younger, 5-35 team members
0 Youth Reueational
9 years & l'._OUnger, 5-35 team members
0 Junior Recreational
12 years &jounger, 5-35 team meirliers
0 Senior Recreational
14 years & younger, 5-35 team members
SCHOOL TEAM DIVISIONS
0 Small Junior High
9th grade &
team members
0 large Junior nigh
9th grade & youngeriJ7-25 team members
0 Small Junior varsity
12th grade & 5-16 female team members
0 large Junior varsity
12th & younger, 17-25 lemole team members
0 Junior Varsity Coed
12th grade & younger, 5-25 members one or more moles
0 Small Varsity Division I
12th grade & younger, 5-12 female team members
1300 and above students
0 Small Varsity Division II
12th grade & younger, 5 12 female team members
1-1299 students
0 Medium Varsity Division I
12th grade & younger, 13-16 female team members
0 Medium Varsity Division II
12th grade & younger, 13 16 female team members
1-1299 students
0 large Varsity Division I
12th grade & younger, 1720 female team members
0 large Varsity Division II
12th grade & younger, 1720 female team members
11599 students
0 Super Varsity Division I
12tfi grade & younger, 2130 female team members
0 Super Varsity Division II
12tfi grade & younger, 21 30 female team members
1-1599 students
0 Small Coed Varsity I
12th grade & younger, 520 team members,
4 or less ITllles, 1600 and above students
0 Small Coed Varsity II
12th grade & younger, 520 team members,
4 arless 1T1Jles, 1-159.9 students
0 large Coed Varsity
12th grade & younger, 5 20 team members,
5 or more moles
0 Super Coed Varsity
12tfi grade & younger, 530 team members,
5 or mare moles
NON BUILDING DIVISIONS
0 Junior Non Building
JH or JV sgf!Od, 5-30 teom members
0 Small Varsity Non Building
12th grade & younger, 5 15 team members
0 large Varsity Non Building
12th grade & younger, 1630 teom memliers
NON TUMBLING DIVISIONS
0 Junior Non Tumbling
JH or JV 5-25 teom meirliers
0 Small Varsity Non Tumbling
12th grade & younger, 5 12 team members
tup to 2 ITllles allowed)
0 Medium Varsity Non Tumbling
12th grade & younger, 1320 team members
(up to 2 moles allowed)
0 large Varsity Non Tumbling
12th grade & younger, 2130 team members
(up to 2 moles allowed)
COMMUTER
REGISTRATION FEES
For those learns not purchasing the travel package,
there is a $21 5.00 per person non-refundable or
non-transferable registration fee (advisors included)
This fee includes a 1hree doy Walt Disney Worlcl
PARK-HOPPER Poss to be used for two days of
competition ot Disney's Hollywood Studios
and/or ESPN Wide World of Sports
Complex, and one additional day to visit o
Walt Disney Worlcl Theme Pork of your choice.
(This fee does nol include the Championship Cele-
bration Porty or transportation to porks.)
0 The Celebration Party is an additional $35
per person (this does not include transportolion).
__ Number of tickets I would like to purchase.
0 We would like to upgrade our tickets to four
day PARK-HOPPER Passes for an additional
$30 per person.
__ Number of ti1kets I would like to upgrade.
If your qualifying competition takes
place close to your deadline, we
suggest you have all paperwork
ready to mail immediately after your
competition. Our hotels fill quickly
and sometimes fill prior to
the deadline date.
*If your qualifying competition takes
place in October or November, this
packet & deposit are due
December 2, 2011.
place in December, this packet and
HOTELS MAY FILL UP PRIOR TO
PUBLISHED DEADLINES.
BALANCE OF PAYMENT
15 DUE
JANUARY 5, 2012!
If you have family members flying separately from the teams, we suggest they register with
us se aratel in order to receive their tickets, nameta s, etc. when the arrive.
PAYMENT POLICIES & DEADLINES
A non-refundable or non-transferable deposit of $100 per person is due in the NHSCC office on
the following dates:
If your qualifying competition takes place in October or November, your deadline for deposit is
December 1, 2011.
If your qualifying competition takes place in December, your deadline for
deposit is December 1 S, 201 1 .
RESERVATIONS RECEIVED AFTER YOUR DEADLINE WILL BE
ACCEPTED BASED ON HOTEL AVAILABILITY.
Balance of payment is due in the NHSCC office no later than January 5, 2012.
Please Note: Squads will not be officially registered with the NHSCC until deposits are received.
Your squad may use a purchase order from the school, school check, cashier
check, money order or credit card for payment. If deposit/balance is made by school
purchase order and cancellation occurs after January 5, 2012 all cancellation fees will apply.
If the balance of payment is not received by January 5, 2012, and written arrangements are not
made and approved by the NHSCC prior to the January deadline, all room reservations will be
cancelled, which will result in a complete forfeiture of monies paid.
No changes can be made after JANUARY 11, 201 2.
If you have changes after this date, there will be a $50 fee per change.
*Every squad must he paid in full three weeks prior la the
championship regardless of written arrangements
ACCOMMODATIONS
2012 NATIONAL Hl&H SCHOOL CHEERLEADIN& CHAMPIONSHIP
Schaal/Team Hame City/State
DIRECTIONS:
l. Choose the hotel you wish to stay in (Disney's All Star Resort or Disney' s Caribbean Beach Resort)
under the package that you wish to purchase.
2. Choose the type of room you wish to stay in (quad, triple, double or single)
3. Return with a $100.00 (non-refundable or transferable) per person deposit to the NHSCC office.
If your qualifying competition takes place in October or November, this packet and deposit are due December 1, 2011.
If your qualifying competition takes place in December, this packet and deposit are due December 1 S, 2011.
HOTELS MAY FILL UP PRIOR TO PUBLISHED DEADLINES.
All Walt Disney o r l ~ Theme Park tickets are valid January 30 - February 18, 2012.
0 FOUR NIGHTS PLEASE CHOOSE ONE: 0 TWO NIGHTS PLEASECHOOSEONE:
DISNEY'S ALL STAR RESORT
DISNEY'S CARIBBEAN BEACH RESORT
Travel package price for the four nights af:
PLEASE CHOOSE ONE:
February 9 (check-in) through February 13 (check-out) includes:
February 10 (check-in) through February 14 (check-out) ar
Four nights and five days hotel accommodations
Special "UCA Night" at the Magic Kingdom"' Pork*
Championship Celebration Porty
Round trip airport transfers through Disney's Magical Express
!Orlando International Airport ONLY)
Four day Walt Disney o r f ~ PARK-HOPPER Pass
Three days admission into ESPN Wide World of Sports"' Complex
Two counter service meal vouchers !One entree, dessert and beverage per voucher-at designated
Theme Pork dining locations. lunch or Dinner ONLY.)
Transportation to all NHSCC events
All taxes and gratuities
ALL STAR RESORT CARIBBEAN RESORT
Quad (4 per roam) .......................... $477.00 per person .................... $547.00 per person
Triple (3 per room) .......................... $519.00 per person .................... $599.00 per person
Double (2 per roam) ........................ $609.00 per person .................... $708.00 per person
Single (1 per room) .......................... $849.00 per person .................. $1037.00 per person
(NONE OF THE ABOVE PRICES INCLUDE AIRFARE.)
You may upgrade your Four Day PARK HOPPER to a 5 Day PARK HOPPER
for an additional $30 per person. Please indicate this on your rooming list.
0 THREE NIGHTS PLEASECHOOSEONE:
The travel package price for the three nights of February 10 (check-in) through
February 13 (check-out) includes:
Three nights and four days hotel accommodations
Special "UCA Night" at the Magic Kingdom"' Pork*
Four day Walt Disney o r f ~ PARK-HOPPER Poss
Three days admission into ESPN Wide World of Sports Complex
Two counter service meal vouchers !One entree, dessert and beverage per voucherot designated
Theme Pork dining locations. lunch or Dinner ONLY.)
Transportation to all NHSCC events
Quod (4 per room) .......................... $451.00 per person .................... $503.00 per person
Double (2 per room) ........................ $546.00 per person .................... $617.00 per person
Single (1 per room) .......................... $739.00 per person .................... $861.00 per person
* You will need to use your WDW Pork Hopper Pass in order to offend this event!
The travel package price for the two nights of February 10 (check-in) through
Two nights and three days hotel accommodations
Special "UCA Night" at the Magic Kingdom"' Park*
Three day Walt Disney o r f ~ PARK-HOPPER Poss
Three days admission into ESPN Wide World of Sports Complex
One counter service meal voucher !One entree, dessert and beverage per voucher-at designated
Theme Pork dining locations. lunch or Dinner ONLY)
Tronsportolion to all NHSCC events
Quad (4 per room) .......................... $401 .00 per person .................... $449.00 per person
Single (1 per room) .......................... $591.00 per person .................... $704.00 per person
EXTRA NIGHTS
(ONLY WITH THE FOUR NIGHT TRAVEL PACKAGE!)
PLEASE CHOOSE ONE:
I would like to stay an extra night on (check All that apply):
Wednesday Thursday Tuesday
Fe. 8, 2012 Fe. 9, 2012 Fe. 14, 2012
Optional Extra Nights !Wednesday, February 8, Thursday, February 9 or T uesdoy,
February 14). Since the hotel hos very limited space avai lable for these nights,
reservations for the extra nights will be accepted on o first come.first served basis Disregard this
section if you pion to stay the regular four nights and five days.
All roams ..... . .. . ...... .... .. Sl 19.00 per room ...................... $200.00 per room
(regardless al ai:i:upancy)
Commuter Participant Fee: $215
For those participants not purchasing the ttovel package, there is a $215 per participant registration
fee. This fee includes:
Three Doy Walt Disney o r t ~ PARK-HOPPER Poss
Al l registration fees for the NHSCC
PLEASE MAKE CHECKS PAYABLE TD NHSCC!
MAILING ADDRESS:
NHSCC P.O. Box 752790 Memphis, TN 38175-2790
OR TO FED EX YOUR REGISTRATION:
67 45 Lenox Center Court Suite 300 Mem his TN 38115
ROOMING LIST
School/Team Name City State __ _
0 Disney's All-Star Resort 0 Disney's Caribbean Beach Resort
Medical Forms needed: Total # of Adults Total # of Minors
---
* Medical Release forms are required for coaches and participants only!
IMPORTANT: This form must be completed in order for your registration to be accepted. Reservations will be entered according to the
dates below and charged as such. List below names in full of people staying in either quad (4), triple (3), double (2), or single (1 ), rooms.
In parenthesis, specify one of the following for each person: (P) =Participant (A)= Advisor (F) =Family/Friend
PLEASE NOTE: Rollaway beds are not avadable. (PLEASE PRINT OR lYPE) 0 Upgrade to 5 Day Park Hopper (Please color in for upgrades only)
SINGLES (ONE IN EACH ROOM)
l.
l.
DOUBLES (TWO IN EACH ROOM)
l. (
2.
l.
2.
TRIPLES (THREE IN EACH ROOM)
l. (
2.
3.
l.
2.
3.
l.
2.
3.
l.
2.
3.
4.
l.
2.
3.
4.
l.
2.
3.
4.
QUADS (FOUR IN EACH ROOM)
P/A/f
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
(
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
A11ivol Dote
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
) (
)
) (
) (
) (
(
) (
) (
) (
) (
) (
DeportDate Ticket
Upg1ade
SINGLES (ONE IN EACH ROOM)
P/A/f Date Deport Date Ticket
Upgmde
) 0 l. ) ( ) ( ) 0
) 0 l. ) ( ) ( ) 0
) 0 l. ) ( ) ( ) 0
------------------
) 0 2. ) ( ) ( ) 0
------------------
) 0 l. ) ( ) ( ) 0
------------------
) 0 2. ) ( ) ( ) 0
------------------
) 0 l. ) ( ) ( ) 0
------------------
) 0 2. ) ( ) ( ) 0
------------------
) o _3. __________ 1_1 __ 1_ 1 __ l _o
) 0 _l. ________
1
o _2. __________ 1_1 __ 1_ 1 __ l _o
) 0 _3. __________ )_( __ )_ ( __ ) 0_
) 0 _4. ________ --'-_)_ ( __ )---'- (
) 0 _l. __________ )_( ___ ( __ ) 0_
) 0 _2. __________ )_( ___ ( __ ) _0
) 0 _3. __________ )_( __ )_ ( __ ) 0_
) 0 _4. __________ )_ ( __ )_ ( __ ) 0_
1 o _l. __________ 1_1 __ 1_1 __ l _o
1 0
_2. __________ 1_1 __ 1_1 __ l _o
1 0
_3. __________ 1_1 __ 1_1 __ l _o
) 0 _4 . ___________ ) _( __ ) _ ( __
*Any changes made after January 11, 2012 will result in a $50 fee per change.
This INCLUDES rooming changes or name changes not provided prior to January 5, 2012. This form is due with registration.
AIRPORT TRANSPORTATION
If you need transportation to and from the Orlando International Airport, you must read this
information carefully. We will be sending you a transportation packet of important instructions
for setting up your transportation to and from the airport. This packet should arrive about
4 weeks prior to the event.
7l!SD&HS l l G I l l ~ EIPHCSS
* Transportation between Orlando International Airport and the Walt Disney World Resort will be
provided by Disney's Magical Express. Attendees utilizing another airport will need to find
alternate transportation.
* Disney's Magical Express provides motorcoach transportation to/from the Walt Disney World
Resort and special luggage delivery service.
* Disney's Magical Express requires a reservation. Each guest must be registered at a Walt Disney
World Resort prior to contacting Disney's Magical Express.
* After registering for the event, each team will be provided with specific details to book their
Disney's Magical Express reservation. Reservations need to be completed 14 days prior to arrival.
Guests will be asked to provide a mailing address and inbound/outbound flight information.
* Disney's Magical Express will mail Airport Transportation Booklets which include detailed arrival
instructions and special luggage tags.
* Disney's Magical Express luggage service is not available after 10:00 pm. If you or your team
arrives after 10:00 pm you will be responsible for claiming your luggage and bringing it with you
on the Disney's Magical Express buses.
CANCELLATION POLICY
School/Team Name ______________ Cdy __________ Slale ____ _
For cancellations received on or before January 5, 2012, all monies will be refunded with the exception of the one hundred dollars ( $100.00) per
person deposit. For cancellations between January 6 and January 13, 2012, an additional $ l 00.00 per person penalty will apply to cover hotel
and entertainment guarantees. Cancellations received after January 13, 2012 will result in a FULL FORFEITURE of all monies due. All cancellations
must be in writing to the National High School Cheerleading Championship. We will not accept cancellations by phone. Deposits from cancella-
tions cannot be applied toward your balance. CANCELLATIONS can be emailed to mmiller@varsityspirit.com, or faxed to atten-
tion: Missy Miller at 1-800-969-8295 or 901-387-4357.
I have read the cancellation policy and understand and accept its contents. I have also advised all participants, parents and chaperones of
my group of this cancellation policy. I will also make sure that this account is paid in full , including any extra fees as a result of cancellation.
Advisor/Cooch's Signature Dote
Principal Signature Dote
Each adult traveling on the travel package and each participant' s parent must sign below. We have read the cancellation policy and under-
stand and accept its contents. Your application will not be entered without ALL signatures.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11. 21. 31.
12. 22. 32.
13. 23. 33.
14. 24. 34.
15. 25. 35.
16. 26. 36.
17. 27. 37.
18. 28. 38.
19. 29. 39.
20. 30. 40.
*If your qua6fying competition takes place in October or November, this packet and deposit are due December 2, 2011.
*If your qua6fying competition takes place in December, this packet and deposit are due December 1 S, 2011.
Balance of payment is due January S, 2012.
CREDIT CARD PAYMENTS
School/Team Name City _____ _
If any family members wish to charge their deposit or balance of payment on a credit card, we accept VISA, MasterCard,
Discover or American Express. Below list the person wishing to charge, their credit card number, expiration date and
amount to be charged along with their signature. Please send this information along with your registration.
(One form per family group.)
CREDIT CARD TYPE: O VISA o MC O AMEX O DISC Exp. Date:_/_/_ Total Amount Charged: $ _____ _
AccountNumber: DODD DODD DODD DODD
0 Deposit or 0 Balance of Payment*
Nome (Print) Signature
Billing Address Daytime Telephone Number
City, State Zip
Email Address
If this credit card payment is not for your entire group, please list person(s)
and amounts to be paid with this credit card.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Person(s) Amount
~
Cell Phone Number
*Please complete this form for each charge (i.e. charge your deposit in December and then complete
another charge form in January to charge your balance). Send a separate sheet for deposit and balance
of payment.
BALANCE OF PAYMENT IS DUE JANUARY 5, 2012.
* In order for credit cards to be processed, we MUST have the billing address for the credit card being charged.
This address MUST include the zip code for the billing address.
THIS FORM MAY BE DUPLICATED.
TEAM ROSTER
School/Team Name
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
Division
Address _______________ Ci ty ______ S tat e ___ Z i p ____ _
School Enrollment as of October 1, 2011
Please list the names of all participants that are performing on the Floor at The National High School Cheerleading Championship.
All members of the cheerleading team must be current members of the official school/ recreational spirit team and must attend the
school they are representing. (Exception: this will not preclude participation from sister schools for same-gender schools as long as
they are official members of the team.) Junior Varsity Teams must be the official Junior Varsity Team or a Junior High team with a
majority of 9th grade team members.
q, ~
~ ~
Participant's Nome -< iJ!!
Participant's Nome
1.
0 0
16.
2.
0 0
17.
3.
0 0
18.
4.
0 0
19.
5.
0 0
20.
6.
0 0
21.
7.
0 0
22.
8.
0 0
23.
9.
0 0
24.
10
0 0
25.
11.
0 0
26.
12.
0 0
27.
13.
0 0
28.
14.
0 0
29.
15.
0 0
30.
Team Alternates
1. 3.
2. 4.
Please list up to three coaches names that you would like listed on video screen at the event:
ON BEHALF OF MY TEAM, I HEREBY ACCEPT THE TEAM ROSTER AND ENROLLMENT GUIDELINES AND
AGREE TO ABIDE BY THESE RULES.
(Advisor Name Print) (Advisor Sgnature)
(Principal's Name Print) (Principal' s Signature
Retain a copy of these rules for your files
This form is due with registration no later than December 5, 2011.
-!!!
~
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-.!!:'
0
E:
iJ!!
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
School/Team Name ___________ _ City /State Division
(i.e. Small Coed, Junior High, etr:.}
Please complete the form below and return with your balonce of payment by Jonuory 5, 2012.
IMPORTANT: All music (including entire songs or any portion of any song) must be listed below in the order of your routine.
Any violation of this rule may wbject the team lo disqualification from the Championship and any associated television programs.
For help visit www.bmi.com or www.ascap.com or www.sesac.com
Publisher length of Nome of the Record
Song Title Artist's Name Song Writerisl Nome Song Publisher(s) Nome Affiliati on Time the Lobel for CD/Tope
(BMI, ASCAP, Song is Used
SESAC)
1.
2.
3.
4.
5.
6.
7.
Signature of Official School/Team Advisor Date
~ z
N c:::
z
!:; In
_ ....
1n
~ ....
Z
a..,..
: Cl
! :II
-z
~
i.! ....
=Cl
1:1 z
-
I m
! ::c
:Di l:P.I
3: ...
::!
I tiiii
UI
!
"II
MUSIC INFORMATION SHEET
2012 HIGH SCHOOL CHEERLEADING CHAMPIONSHIP
ORIGINAL MUSIC AND/OR SOUND EFFECTS FORM
DO NOT FILL OUT THIS FORM UNLESS YOU ARE USING ORIGINAL MUSIC AND/OR SOUND EFFECTS
Squad/Team Name
Division
------------------
Coach/ Advisor's Name
Daytime Phone { __ _,
I understand that the music and/or sound effects are works for hire under the U.S.
Copyright Law. All rights to use music and/or sound effects are hereby assigned to Uni-
versal Cheerleaders Association, Universal Dance Association, and Varsity Spirit Corpora-
tion in Perpetuity.
Name of Song
Artist
------------------
Type of Sound Effect -------------
Signature -----------------
MUSIC INFORMATION - FAO
NOTARY SEAL:
Signature
My Commission Expires
1. What is ASCAP /BMl/SESAC? Why does our music have to be licensed by one of these companies?
ASCAP, BMI, and SESAC are music licensing companies. Music licensing laws require us to have this
information on file when we play your music at competition and/ or if your routine is shown on television.
2. Is it necessary to complete the original music and/ or sound effects form if sound effects are used?
If spoken words or sound effects are CREATED by a DJ or person, this is considered original music and the
original music/ sound effects form should be completed.
If the sound effect is from a CD, this does not count as a song, and you do not have to fill out the original
music/ sound effect form. If spoken words from a song are used, it counts as a song and should be listed on
the music information sheet.
DO NOT FILL OUT THIS FORM UNLESS YOU ARE USING ORIGINAL MUSIC AND/OR SOUND EFFECTS
THIS FORM IS DUE IN OUR OFFICE NO LATER THAN January 6, 2012
THIS FORM MAY BE DUPLICATED FOR USE OF MORE THAN ONE SOUND EFFECT
EXTRA TICKET ORDER FORM
NOTE: Transportation is NOT included with purchase of these tickets.
h"ol/Teom Nome City Stole
Nome (NOTE: Only the person li sted here wi ll be able lo sign for and pick up ALL lickels in Orl ando!)
Address
( ) )
1e Phone Work Phone Cell Phone
Address
WALT DISNEY WORLD TICKETS AVAILABLE FOR PURCHASE
0 THREE DAY PARK-HOPPER - $196.00 each Number Needed __ _
(NHSCC Transportation is not included) (* Includes three days admission to ESPN Wide World of Sports Complex.)
0 FOUR DAY PARK-HOPPER - $226.00 each Number Needed __ _
(NHSCC Transportation is not included) (*Includes three days admission to ESPN Wide World of Sports Complex.)
0 FIVE DAY PARK-HOPPER - $256.00 each Number Needed __ _
(NHSCC Transportation is not included) (* Includes three days admission to ESPN Wide World of Sports Complex.)
0 MEAL VOUCHERS - $16.00 each
(Lunch or Dinner ONLY! One entree, dessert and beverage per voucher
designated theme pork dining locations.)
0 SUNDAY EVENING CELEBRATI ON PARTY AT
DISNEY' S HOLLYWOOD STUDI OS - $35.00 each
(NHSCC Transportation is not included)
Refunds will not be given for Celebration wristbands.
Number Needed __ _
Number Needed __ _
Tickets can be picked up in Orlando at the hotel your squad is housed in at the designated
NHSCC registration area on Thursday, February 9th, and Friday, February 10th. Saturday
morning February 11th, tickets can be picked up at the national championship office at your
hotel. If your squad is NOT staying at one of the NHSCC travel package hotels, please pick
up your tickets at the Disney's All-Star Resort NHSCC Registration Area (Celebrity Hall).
I will pick up my extra ticket order at: 0 All Star Resort 0 Carribean Beach Resort
METHOD OF PAYMENT: Enclosed is check number for S __ _
I authorize the National High School Cheerleading Championship to charge my
0 VISA 0 M C 0 AM EX 0 DISC in the amount of $ for tickets.
-----
Account Number DODD DODD DODD DODD
Expiration Date ______ _
Name an Credit Card -------------------------
Card Holder Billing Address*
Card Holder City, State, Zip ______________________ _
Card Holder Daytime Phone (
_________ Cell I
Cord Holder Signature ________________________ _
Cord Holder Email Address
* In order for credit cords to be processed, we MUST hove the billing address for the credit cord being
charged. This address MUST include the zip code for the billing address .
THIS FORM IS FOR
FAMILY AND FRIENDS
NOT PURCHASING THE
NHSCC TRAVEL PACKAGE.
Squad members not attending on the
travel package DO NOT need to
complete this form
Every family needs lo fill out a
form. Please do NOT combine
families on one order form.
This form and full payment
are due in the
National High School
Cheerleading Championship
Office by January 20, 2012.
Credit Cord orders may be foxed t
1-800-969-8295 or
1-901-387-4357
If confirmation 1s not received within
2 weeks, verficotion should be directed to
Koy Canon at the emoi address bel< JW
kcotton@vorsitysp1r;t.com
Checks and 101 ms ore to be
mrnled to.
NHSCC TICKET ORDERS
P.O. Box 752790
MEMPHIS, TN 381752790
No extra ticket orders will be
accepted ofter January 20, 2012
After the deadline, tickets may be
purchased in Orlando
at Celebrity Holl. (limited available)
ORDERS THAT ARE NOT PAID
IN FULL WILL NOT BE
PROCESSED!
You MAY MAKE COPIES OF THIS FORM
TICKETS ARE VALID FROM JANUARY 30- FEBRUARY 18, 2012
RULES AND REGULATIONS
(BOLD print indicates a change in rules-please NOTE that some rules have changed!!!}
GENERAL RULES:
A. PERFORMANCE ROUTINE DIVISIONS
1. SCHOOL DIVISIONS
Junior High Divisions (9th grade & below):
Small Junior High - 5-16 members
Large Junior High - 17-25 members
Junior High teams may include 9
1
h grade participants IF ( 1) the school repre-
sented includes a 9th grade class AND (2) a minority of the team are 9
1
h
graders. Junior High teams with a majority of 9
1
h graders would compete as a
Junior Varsity.
Junior Varsity Divisions (12th grade & below) :
Small Junior Varsity- 5-16 members - female
Lorge Junior Varsity - 17-25 members - female
Junior Varsity Coed - 5-25 members -one or more moles
Varsity Divisions (12th grade & below):
Small Varsity - 5-12 female members
Medium Varsity- 13-16 female members
Lorge Varsity - 17-20 female members
Super Varsity - 21-30 female members
Small Varsity Coed - 5-20 members - 1 - 4 moles
Lorge Varsity Coed - 5-20 members - 5 or more moles
Super Varsity Coed - 5-30 members - S or more males
Non Building Divisions (12th grade & below) :
Junior Non Building - 5-25 members - JH or JV team
Small Varsity Non Building-5-15 members
Lorge Varsity Non Building-16-30 members
Non Tumbling Divisions (12th grade & below):
Junior Non Tumbling - 5-30 female members- JH or JV team
Small Varsity Non Tumbling - 5-12 members - 0-2 moles
Medium Varsity Non Tumbling - 13-20 members - 0-2 moles
Lorge Varsity Non Tumbling - 21-30 members - 0-2 males
New - ''The Non-Tumbling division will prohibit all tumbling with feet over head
rotation. Legal inversions into or from stunts will not be considered tumbling
and are allowed in this division."
Varsity Divisions for the NHSCC
Varsity Divisions will be subdivided based on school enrollments in the
9
1
h - 12'h grades as of October 1, 2011 .
Small Varsity Division I - 1300 & above Students
Small Varsity Division II - 1-1299 Students
Medium Varsity Division I - 1300 & above Students
Medium Varsity Division II - 1-1299 Students
Lorge Varsity Division I - 1600 & above Students
Lorge Varsity Division II - 1 - 1599 Students
Super Varsity Division I - 1600 & above Students
Super Varsity Division II - 1 - 1599 Students
Small Varsity Coed Division I - 1600 & above Students
Small Varsity Coed Division II -1 - 1599 Students
YOUTH/RECREATIONAL DIVISIONS
Youth / Recreational Divisions:
Pee Wee Rec - 5-35 members - 7 yrs & younger
Youth Rec - 5-35 members - 9 yrs & younger
Junior Rec - 5-35 members -12 yrs & younger
Senior Rec - 5-35 members - 14 yrs & younger
Teams with a school affiliation may compete in the youth recreational division,
only if at least half of the participants ore in the 6
1
h grade or younger.
Teams with a school affiliation that hove a majority of 7
1
h and B'h graders must
compete in the junior high division.
a. These divisions were created for teams whose main purpose is cheering
and supporting a recreational team (i.e. youth football, pee wee sports,
community sport teams, etc.) Competitive only youth programs ore consid-
ered on all star program, and must compete as an all star team and follow
all star rules and regulations.
b. Youth divisions are determined by the age of the oldest team member.
c. See additional skill restrictions for these divisions (XI Safety Rules Section I)
d. The competitor's age on August 1, 2011 shall be the competitor's age
through the Notional High School Cheerleading Championship in February
2012.
B. SCHOOL REPRESENTATION AND
TEAM PARTICIPATION
1. All members of the cheerleoding squad must be current members of the offi-
cial school spirit squad and must attend the school they ore representing.
(Exception: this will not preclude participation from sister schools for some-
gender schools as long as they are official members of the squad.)
2. The team and each participating member/coach should constantly display
good sportsmanship throughout the entire performance in regards to re-
spect for themselves, other teams and the viewing audience of all ages.
Teams should refrain from any taunting, bragging, or suggestive expres-
sions or gestures as well as discrimination of any nature.
C. UNIFORM GUIDELINES
1. All participant uniforms must cover the midriff when standing at attention.
Covered midriff does include flesh or nude colored body suits and liners;
however, fringe would not count as a cover.
2. Any team in violation of the uniform guidelines will be assessed a five (5)
point deduction.
D. TIME LIMITATIONS
1. Performance Routine
1. Each team's presentation must include at least one cheer or sideline
chant. The musical portion must not exceed one minute and thirty
seconds. Total time limit is two minutes and thirty seconds.
Timing will begin with the first movement, voice, or note of music,
whichever comes first.
2. If a team exceeds the time limit, a penalty will be assessed for each vio-
lation. Three (3) point deduction for 3 - 5 seconds over, Five (5) point
deduction for 6-10 seconds over and Seven (7) point deduction for 11
seconds and over.
3. BECAUSE PENALTIES ARE SEVERE, IT IS RECOMMENDED THAT ALL
TEAMS TIME THEIR PERFORMANCE SEVERAL TIMES PRIOR TO
COMPETITION AND LEAVE A SEVERAL SECOND CUSHION TO
ALLOW FOR VARIATIONS IN SOUND EQUIPMENT.
4 . All introductions (tumbling, entrances, chants, spell-outs, etc.) are
considered port of the routine and ore timed as part of the
performance. There should not be any organized exits or other
activities after the official ending of the routine.
E. MUSIC
1. Teams may use on unlimited number of songs in their routine at all com-
petitions.
2. Due to television network requirements, all music used by teams compet-
ing at the Notional High School Cheerleoding Championship must be li-
censed by either ASCAP, BMI or SESAC. Any violation of the licensing
requirement will subject the team to disqualification from the Champi-
onship and omission from any associated television programs.
3. Teams may not use Disney themes, however, Disney music that is
ASCAP, BMI or SESAC is acceptable.
F. COMPETITION PERFORMANCE AREA
1. Participants must start in the competition area with at least one foot on
the ground.
2. Teams may line up anywhere inside the competition area.
3. UCA Competitions comply with the NFHS & AACCA surface ruling that
school based programs may not compete on a spring Acors.
4. Approximate Acor size will be 54 feet wide by 42 feet deep (9 strips).
5. Signs or props may be placed or dropped outside the competition area
by a team member who must remain inside the competition area.
6. BOUNDARY FOR THE NHSCC - Any squad member stepping outside
or touching outside the performance area will cause the squad to
receive a .5 penalty per occurrence.
G. NHSCC QUALIFICATION:
1 . All teams must compete in the some division at the Notional Championship
in which they qualified.
2. Individuals may NOT represent more than one team at the National Cham-
pionship.
3. It is understood that teams that participate in the National High School
Cheerleoding Championship will NOT knowingly and willingly participate
in any other cheerleading event promoted as a notional or international
championship for the 2011-2012 school year. (Exception: USA Notional
Championship) Teams who violate this with rule will be subject to disqualifi-
cation and will forfeit the opportunity to participate in the subsequent Na-
tional High School Cheerleading Championship.
H. SPOTIER POLICY
In an effort to promote a higher level of safety for competing athletes, Varsity
will provide additional spotters at all Varsity school and recreational cheer com-
peti tions. School and Recreational cheer programs do not always have a large
number of staff and coaches available to spot routines. To ensure that the safety
of participants is not compromised due to limited number of team provided
spotters, additional spotters will be provided by the competition company.
Guidelines:
1. Competition provided additional spotters will be mandatory on the competi-
tion floor.
2. At select events, a limited number of additional spotters may be available
upon coaches' request in rehearsal/warm up.
3. School-based teams and recreational teams may provide additional spotters
in rehearsal/warm up.
Definition of Additional Spotter:
Individuals on the competition floor provided as a safety precaution to spot cer-
tain el ements of a routine. Competition provided additional spotters will follow
the listed guidelines:
Additional Spotters:
1. Should only be used during the stunt, pyramid, and/or basket toss sections.
Additional spotters are present for added safety and should stand at the
back of the floor when not spotting those sections.
2. Should not touch, assist, or save skills being performed. Additional spotters
should only be used to prevent a fall to the competition floor.
3. Should be dressed so that they are presentable, professional , and distin-
guishable from the performing athletes.
4. Should not dress or act in a manner that distracts from the athletes and their
perform a nee.
5. Should be at least 18 years old and familiar with spotting the skills of the
performing team.
Note: To provide the safest competitive environment, teams should not attempt
skills beyond their ability level.
II. INTERRUPTION OF PERFORMANCE
A. UNFORSEEN CIRCUMSTANCES
1. If, in the opinion of the competition officials, a team's routine is interrupted
because of Failure of the competition equipment, facilities, or other factors
attributable to the competition rather than the team, the team affected
should STOP the routine.
2. The team will perform the routine again in its entirety, but will be evaluated
ONLY from the point where the interruption occurred. The degree and ef-
fect of the interruption will be determined by the competition officials.
B. FAULT OF TEAM
1. In the event a team's routine is interrupted because of failure of the team's
own equipment, the team must either continue the routine or withdraw from
the competition.
2. The competition officials will determine if the team will be allowed to per-
form at a later time. If decided by officials, the team will perform the rou-
tine again in its entirety, but will be evaluated ONLY from the point where
the interruption occurred.
C. INJURY
l . The only persons that may stop a routine for injury are: a) competition offi-
cials, b) the advisor I coach from the team performing or c) an injured in-
dividual.
2. The competition officials will determine if the team will be allowed to per-
form at a later time. If the competition officials allow a routine to be per-
formed at a later time, the spot in the schedule where the re-performance
is to take place is at the sole discretion of competition officials. The team
may perform the routine again in its entirety, but will be evaluated ONLY
from the point where the interruption occurred.
3. The injured participant that wishes to perform may not return to the compe-
tition floor unless:
a. The competition officials receive clearance from, first, the medical
personnel attending to that participant, the parent (if present) AND
THEN the head coach/advisor of the competing team.
b. If the medical personnel do not clear the participant, the participant
can only return to the competition if a parent or legal guardian in
attendance signs a return to participation waiver. In the event of a
suspected concussion, the participant cannot return to perform with-
out clearance from a medical professional, even with a waiver from
a parent or legal guardian.
Ill. HOW TO HANDLE PROCEDURAL QUESTIONS
A. RULES & PROCEDURES
Any questions concerning the rules or procedures of the competition will be
handled exclusively by the advisor/ coach of the team and will be directed to
the Competition Director. Such questions should be made prior to the team's
competition performance.
B. PERFORMANCE
Any questions concerning the team's performance should be made to the Com-
petition Director immediately after the team's performance and/or following the
outcome of the competition.
IV. INTERPRETATIONS AND / OR RULINGS
Any interpretation of these Rules and Regulations or any decision involving any
other aspect of the competition will be rendered by the Rules Committee. The
Rules Committee will render a judgment in an effort to ensure that the competi-
tion proceeds in a manner consistent with the general spirit and goals of the
competition. The Rules Committee will consist of the Competition Director,
Head Judge, and a designated competition official.
V. SPORTSMANSHIP
All participants agree to conduct themselves in a manner displaying good
sportsmanship throughout the competition with positive presentation upon entry
and exit from the performance area as well as throughout the routine. The advi-
sor and coach of each team is responsible for seeing that team members,
coaches, parents and other persons affiliated with the team conduct themselves
accordingly. Severe cases of unsportsmanlike conduct are grounds for disquali-
fication.
VI. DEDUCTIONS
Any team in violation of these Rules and Regulations or any of the above men-
tioned guidelines will be assessed a ten point (10) deduction for each violation.
This deduction does not apply to violations mentioned above that are desig-
nated a lesser point value.
VII. DISQUALIFICATION
Any team that does not adhere to the terms and procedures of these "Rules and
Regulations" will be subject to disqualification from the competition, will automati-
cally forfeit any right to any prizes or awards presented by the competition.
VIII. FINALITY OF DECISIONS
By participating in this competition, each team agrees that the decisions by the
judges will be final and results may ONLY be reviewed for clarification. Each
team acknowledges the necessity for the judges to make prompt and fair deci-
sions in this competition and each team therefore expressly waives any legal ,
equitable, administrative or procedural review of such decisions.
IX. SCORES AND RANKINGS
Individual score sheets are for the exclusive use of each particular judge. Each
judge has the responsibility and authority to review and submit his or her final
scores and rankings prior to the final tally of the scores for all teams. Scores
and rankings will be available only to coaches or captains at the conclusion
of the competition.
X. JUDGING CRITERIA
The judges will score teams using the criteria listed on the UCA score sheet.
Each team will be evaluated on a l 00 point system. Cheer will count for 35
points and 65 points for the Music section of the routine. Each section will be
averaged and then combined for the final score. Any deductions or violations
will be taken off of the final averaged score. For more information on scoring,
score sheet and judging criteria, please visit uca.varsity.com.
JUDGING SHEET
CHEER SCORE SHEET 35 POINTS
CROWD LEADING I 5 POINTS
Crowd Effective Material (Easy lo Follow, Encourages Crowd Participation ( l 0)
Use of Motion lo Lead the Crowd (5)
INCORPORATIONS I 5 POINTS
Proper use of Skills lo Effectively Lead the Crowd (5)
Use of Signs or Porns or Megaphones (5)
Execution of Incorporations (5)
OVERAil CHEER EXECUTION 5 POINTS
MUSIC SCORE SHEET 65 POINTS
PARTNER STUNTS
EXECUTION / TECHNIQUE I 0 POINTS
Form, Synchronization, Spacing
DIFFICULTY I 0 POINTS
Level of Skill, Number of Bases, Transitions, Variety
(Coed Divisions - Unassisted vs. Assisted Coed Stunts)
PYRAMIDS
DIFFICULTY 5 POINTS
GROUP TUMBLING
RUNNING
STANDING
JUMPS
5 POINTS
5 POINTS
EXECUTION & DIFFICULTY 5 POINTS
Synchronized Squad Jumps, Jump Technique, Type of Jump, Synchronization, Spacing
DANCE
Sharpness, Motion Placement, Synchronization, Spacing
OVERAil EFFECT
Choreography, Transitions, Flow of Routine, Visual Appeal
Age-Appropriate Material, Music Selection, Natural Appearance
TOTAL POINTS POSSIBLE: IOOPOINTS
5 POINTS
10 POINTS
CROWD LEADING
COED JUDGING SHEET
(For Large and Super Coed Divisions}
Crowd Effective Material (Easy lo Follow, Encourages Crowd Participation (l 0)
INCORPORATIONS
OVERALL CHEER EXECUTION
PARTNER STUNTS
EXECUTION
DIFFICULTY
USE OF COED SKILLS
PYRAMIDS
EXECUTION / TECHNIQUE
DIFFICULTY
GROUP TUMBLING
RUNNING
STANDING
JUMPS
EXECUTION & DIFFICULTY
15 POINTS
15 POINTS
5 POINTS
10 POINTS
IOPOINTS
5 POINTS
10 POINTS
5 POINTS
5 POINTS
5 POINTS
5 POINTS
OVERALL EFFECT
Choreography, Transitions, Flow of Routine, Visual Appeal
TOTAL POINTS POSSIBLE: 100 POINTS
NON BUILDING JUDGING SHEET
10 POINTS
CROWD LEADING I 5 POINTS
Crowd Effective Material (Easy to Follow, Encourages Crowd Participation ( l 0)
INCORPORATIONS I 5 POINTS
OVERALL CHEER EXECUTION 5 POINTS
STANDING TUMBLING
DIFFICULTY 5 POINTS
Synchronized Squad Tumbling, Level of Skill, Transitions
RUNNING TUMBLING
DIFFICULTY 5 POINTS
Synchronized Passes, Level of Skill, Transitions
JUMPS
Execution of Group Jumps, Difficulty (Type of Jump, Jump Combinations,
Tumbling/Jump Connections), Proper Technique, Synchron_ization, Spacing
DANCE
Technique, Sharpness, Placement, Timing & Spacing
TRANSITIONS
Spacing, Variety, Creativity, Movement
OVERALL EFFECT
Choreography, Flow of Routine, Visual Appeal
TOTAL POINTS POSSIBLE: 100 POINTS
10 POINTS
10 POINTS
5 POINTS
10 POINTS
NON TUMBLING JUDGING SHEET
CROWD LEADING 15 POINTS
Crowd Effective Material (Easy to Follow, Encourages Crowd Participation ( 10)
Use of Motion to Lead the Crowd (5)
INCORPORATIONS 15 POINTS
Proper use of Skills to Effectively Lead the Crowd (5)
Use of Signs or Poms or Megaphones (5)
OVERALL CHEER EXECUTION 5 POINTS
PARTNER STUNTS
EXECUTION 10 POINTS
DIFFICULTY 10 POINTS
PYRAMIDS
EXECUTION
DIFFICULTY
JUMPS
lOPOINTS
10 POINTS
5POINTS
DANCE 5 POINTS
Technique, Sharpness, Placement, Timing & Spacing
TRANSITIONS 5 POINTS
Spacing, Variety, Creativity, Movement
OVERALL EFFECT lOPOINTS
Choreography, Flow of Routine, Visual Appeal
TOTAL POINTS POSSIBLE: lOOPOINTS
NOTE: THE ENDING OF THE ROUTINE SHOULD BE HELD FOR A FEW SECONDS
AND SAFELY DISMOUNTED WITH NO EXCESSIVE CELEBRATING
XI. 2011-2012 SAFETY RULES
Rules subject to change by AACCA. Go to
www.AACCA.org for updates (Rules as of 8/1/2011)
A. Glossary
1. Base: A person who is in direct contact with the performing sur-
face and is supporting another person' s weight.
2. Basket Toss: A stunt in which a top person is tossed by bases
whose hands are interlocked.
3. Bracer: A top person that provides stability to another top per-
son.
4. Cradle: A dismount from a partner stunt, pyramid or toss in
which the top person is caught in a face-up, piked position before
being placed on the performance area or remounting into another
stunt, pyramid or loading position.
5. Cupie/ Awesome: A stunt in which both feet of the top person
are in one hand of a base.
6. Dive Roll: A forward roll where the feet leave the ground before
the hands reach the ground.
7. Elevator/Sponge Toss: A stunt in which the top person loads
in to an elevator/sponge loading position and is then tossed into
the air.
8. Extended Stunt: A stunt in which the entire body of the top per-
son is extended in an upright position over the base(s) . Chairs,
torches, flatbacks and straddle lifts are examples of stunts where
the bases' arms are extended overhead, but are NOT considered
to be extended stunts since the height of the body of the top per-
son is similar to a shoulder level stunt.
9. Hanging Pyramid: A pyramid in which the top person's
weight is primarily supported by another top person. Examples of
hanging pyramids are: a person being suspended between two
shoulder stands; a "whirlybird" stunt where one person's weight is
being supported by the legs of a top person in a shoulder sit; and
a " diamond head" where two persons are suspended from one
shoulder stand.
10. Helicopter: A stunt in which the top person is tossed into the air
in a horizontal position and rotates parallel to the ground in the
same motion as a helicopter blade.
11. Inverted: A body position where the shoulders are below the
waist.
12. Knee Drop: Dropping to the knees without first bearing the ma-
jority of the weight on the hands or feet.
13. Loading Position: A position in which the top person is off the
ground in continuous movement that puts the bases and top in a
position to end the movement in a stunt.
14. Pyramid: Connected partner stunts.
15. Post: A person on the performing surface who may assist a top
person during a stunt or transition.
16. Prop: Any object which can be manipulated or used as a base
(ex: porns, signs, flags, megaphones, etc.)
17. Quick Toss: A toss technique where the top person begins the
toss with both feet on the ground. The bases can apply an upward
force on any part of the body other than under the feet.
18. Released Pyramid Transition: A pyramid transition in which
the top person is connected to a bracer while being released from
their bases and is in a descending mode before being caught in a
cradle, stunt or loading position.
19. Spotter: A person who is responsible for assisting or catching
the top person in a partner stunt or pyramid. This person cannot
be in a position of providing primary support for a top person but
must be in a position to protect the top person's head, neck and
shoulders when coming off a stunt or pyramid or landing in a cra-
dle. Spotters must have their attention focused on the top person
in order to be considered a spotter. Momentarily looking away in
order to assess environmental safety factors (porns, signs, another
stunt, etc.) is allowed as long as their focus returns to the top per-
son.
20. Stunt/Partner Stunt: One or more persons supporting one or
more top persons off of the ground.
21. Suspended Roll: A skill in which a person in contact with bases
or posts performs a foot-over-head rotation .
22. Tension Drop: A dismount from a stunt or pyramid where the
top person(s) are directed toward the ground while their feet are
held by the base(s) until just before the landing.
23. Tic Toe: A stunt that is held in a static position on one leg, the
base(s) takes a downward dip and release the top person as the
top person switches the weight to the other leg and lands in a
static position on the opposite leg. The dip may or may not pass
through prep level before release.
24. Top Person: A person who is not in contact with the performing
surface and is being supported or stabilized by another person or
has been tossed into the air.
25. Toss: An airborne stunt where the base(s) executes a throwing
motion from below shoulder level to increase the height of the top
person and the top person becomes free from all bases, posts or
bracers.
B. General
1 . Cheerleading squads should be placed under the direction of a
qualified and knowledgeable advisor or coach.
2. All practice sessions should be supervised by the coach and held
in a location suitable for the activities of cheerleaders (i.e., use of
appropriate mats, away from excessive noise and distractions,
etc.).
3. Advisors/coaches should recognize a squad's particular ability
level and should limit the squad's activities accordingly. "Ability
level" refers to the squad's talents as a whole and individuals
should not be pressed to perform activities until safely perfected.
4 . All cheerleaders should receive proper training before attempting
any form of cheerleading gymnastics (tumbling, partner stunts,
pyramids and jumps) .
5. Professional training in proper spotting techniques should be
mandatory for all squads.
6 . All cheerleading squads should adopt a comprehensive condi-
tioning and strength-building program.
7 . An appropriate warm-up routine should precede all cheerleading
activities.
8. Prior to the performance of any skill, the immediate environment
for the activity should be taken into consideration including, but
not limited to proximity of non-squad personnel , performance sur-
face, lighting and/ or precipitation. Technical skills should not be
performed on concrete, asphalt, wet or uneven surfaces or sur-
faces with obstructions.
9 . Programs should qual ify cheerleaders according to generally ac-
cepted teaching progressions. Appropriate spotting should be
used until all performers demonstrate mastery of the skill .
10. All jewelry is prohibited during participation. Religious medals
and medical medals are not considered to be jewelry. A religious
medal without a chain must be taped and worn under the uni-
form. A medical alert medal must be taped and may be visible.
11 . Supports, braces and air casts which are hard and unyielding or
have rough edges or surfaces must be appropriately covered. A
participant wearing a plaster-type or other hard, heavy cast shall
not be involved in stunts, pyramids, tosses, tumbling or spotting.
12. Squad members must wear athletic shoes (no gymnastic slippers) .
13. When discarding props (signs, etc.) that are made of solid mate-
rial or have sharp edges/ corners, team members must gently toss
or place the props so that they are under control.
14. The use of mini-trampolines, springboards, spring-assisted floors
or any other height-increasing apparatus is prohibited for compe-
tition or performance. These devices may be used for skill devel-
opment and practice under the supervision of a coach trained in
their use.
C. Inversions
1. The top person may not be in an inverted position with the follow-
ing exceptions:
a. Suspended forward rolls are allowed provided that all of the
following conditions are met:
1. The top person begins in a non-inverted position from the
performing surface or a stunt.
2. The top person has continuous hand-to-hand contact with
two primary bases or with two posts who are controlling the
top person. The top person cannot have contact with one
base and one post or with bracers.
3. The bases or posts cannot be involved in any other skill dur-
ing the suspended roll .
4. The top person lands in a double-based cradle or the per-
forming surface. They may not land in a loading position for
a stunt.
b. The top person may begin a stunt in an inverted position pro-
vided that all of the following conditions are met:
l . The top person begins with at least one hand on the per-
forming surface.
2. The top person is loaded into a non-inverted position shoul-
der height or below.
3. A base or spotter must maintain contact with the top person
until they are in a non-inverted position.
4 . A base or spotter must be in a position to protect the head,
neck and shoulder area of the top person.
c. The top person can be placed on the performing surface in an
inverted position provided that all of the following conditions
are met:
1. The inversion begins from a cradle or prone position below
shoulder level. The cradle or prone position must be estab-
lished prior to the inversion. In other words, the skill cannot
simply "pass through" the cradle or prone position on the
way to the inversion.
2. The inversion goes immediately to the performing surface
with both the top person's hands supporting his or her
weight.
3. Two original bases or an original base and a spotter must
maintain contact with the top person in a position to protect
the head, neck and shoulder area of the top person. This
contact must be maintained until the top person's hands are
on the performing surface.
D. Partner Stunts
1. Partner stunts (free-standing or as part of a pyramid) higher than
shoulder stand level must have a separate, continuous spotter for
each person over shoulder stand level.
2. In single-based extended stunts, the spotter may not support
under the heel or sole of the top person's foot. They may hold at
the ankle of the top person and/or the wrist of the base or any
combination thereof.
3. The top person in a partner stunt must receive primary support
from a base or a bracer who is on a base.
4. The bases of any extended stunt must have both feet in direct
weight-bearing contact with the performing surface.
5. Bases may not hold props in their hands if the hands
are the primary support for the top person.
6 . The total number of twists in a dismount from a stunt cannot be
greater than two and one quarter rotations.
7. Partner stunts and pyramids may not pass over, under or through
other partner stunts or pyramids.
8. Cradle dismounts from partner stunts or pyramids shoulder height
or above to the original base(s) require an additional spotter in
position to protect the head, neck and shoulders of the top per-
son.
9. Cradle dismounts from partner stunts to another set of bases must
be caught by three bases who are standing near the original
base(s) . Any type of gymnastics movement (1 /2 turn, twist, toe
touch, etc) after the top person has left the base(s) hands is
prohibited.
10. The top person cannot be caught in a prone position from a re-
lease unless connected to a bracer.
11 . Non-braced suspended splits in a transition are allowed provided
all of the following conditions are met:
a. There are a total of four bases that support the top person.
b. At least three of the bases must support under the legs of the
top person, and the fourth base may support under the legs
or make contact with the hands of the top person.
c. The top person must have hand contact with bases during
the split portion of the transition .
I
I
: 12. Free-standing tic-toes are prohibited.
: 13. Extended Straddle Lifts must have an additional spotter for the
: head and shoulders of the top person (similar position to a Dou-
'
: ble-Based Elevator /Extension Prep) .
: 14. Single-based stunts in which the top person is parallel to the per-
: forming surface and the bases' arms are extended must have a
I
: continuous spotter at the head and shoulder of the top person.
: (i.e. Bird, Side T, Single-Based Flatback, etc.)
: 15. When the top person falls away from the bases to a horizontal,
I
: straight-body position, a minimum of three catchers are required.
: The bases may not be counted as part of the required catchers.
: 16. When the top person is transitioned to a straight-body position be-
: tween two bases, an additional catcher is required. At least
: one of the catchers must control the upper torso.
I
: 17. Tension drops are prohibited.
: 18. Helicopters are allowed provided all of the following conditions
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
are met:
a. The top person makes no more than a 180 degree rotation
(half-turn) .
b. Four bases must be in position during the entire release.
c. There must be a base at the head/shoulder area during the
initiation of the toss as well as the catch.
d. The bases are not allowed to change positions during the re-
lease.
e. The top person must begin and end in a face up position.
f. The top person cannot perform a twisting skill.
19. Single-based split catches are prohibited.
20. A single-base may not be the only primary support for two ex-
tended top persons. The exception to this rule is the following :
a. Double Cu pies/ Awesomes are allowed. If dismounted to cra-
dles, there must be three people for each top person being
cradled.
21 . Dismounts to the performing surface require assistance from a base
or spotter. This assistance must be sufficient to slow the momentum of
the top person. The exception to this rule is the following:
a. Cradles may be set out to the performing surface without continu-
ous contact.
E. Pyramids
1 . The top person in a pyramid must receive primary support from a
base or be connected to a bracer who is on a base.
2. In braced pyramids, at least one bracer of each pair must be at
shoulder height or below. The exception to this rule is the following:
a. Extensions (double- or single-based) may brace other
extensions.
3. Partner stunts and pyramids may not pass over, under or through
other partner stunts or pyramids.
4. If a person in a pyramid is used as a brace for an extended stunt,
that brace must not be supporting a majority of the top person's
weight. (To demonstrate this, the foot of the top person's braced
leg must be at or above the knee of their supporting leg.)
5. Hanging pyramids must have a continuous spotter for each shoul-
der stand involved in suspending another person. Hanging pyra-
mids are not allowed to rotate.
6. In a Released Pyramid Transition the following rules apply:
a. At least three original bases must be under the top person
throughout the transition.
b. Bracers at shoulder level must have a spotter in place during
the transition movement. (Shoulder sits and double-based
thigh stands do not require an additional spotter.)
c. The top person must be in hand/arm to hand/arm contact
with at least one bracer during the entire transition.
d. The top person may not be supporting his or her weight on
any other body part of the person(s) assisting (i .e. Shoulders
of the bracer) .
e. The top person must be continuous in motion and cannot be
supported so that they pause during the transition.
F. Tosses (including tosses from the performing
surface)
1. In all single-based tosses that land in a stunt all of the following
rules apply:
a. The top person must land in a stunt on the original base.
b. The toss may not be directed so that the base must travel to
catch the top person.
c. The top person cannot travel over or under another person.
d. The top person cannot be caught in a prone position.
2. In all single-based tosses that land in a loading position all of the
following rules apply:
a. Must be caught in a loading position that includes the original
base and a spotter who must be in position to protect the head,
neck and shoulders.
c. The top person cannot perform any skill (twist, toe touch,
ball-up, etc.) during the toss.
d. The top person cannot travel over or under another person.
e. The top person cannot be caught in a prone position.
3. In all single-based tosses to a cradle all of the following rules
apply:
a. Must be caught by at least three catchers that include the
original base, one of whom must be at the head and shoul-
ders.
c. The top person may not hold any objects (porns, signs, etc.)
during the toss.
d. The top person cannot travel over or under another person.
e. The top person cannot perform any skill (twist, toe touch,
ball-up, etc.) during the toss.
f. Tosses to cradles are prohibited on surfaces other than a mat
or grass (real or artificial).
4. In all multi-based tosses to a cradle the following rules apply:
a. No more than four tossers are allowed.
b. Must be caught by at least three of the original tossers, one
of whom must be at the head and shoulders.
c. The toss may not be directed so that the bases must travel to
d. The top person may not hold any objects (porns, signs, etc.)
during the toss.
e. The top person cannot travel over or under another person.
f. The total number of twists cannot be greater than two and
one quarter rotations.
g. Tosses to cradles are prohibited on surfaces other than a mat
or grass (real or artificial).
5. In multi-based tosses that land in a stunt or loading position the
following rules apply:
a. Must be caught by at least two of the original tossers and a
spotter who must be in position to protect the head, neck and
shoulders.
b. The toss may not be directed so that the bases must travel to
c. The maximum distance allowed between the highest point of
the base and the lowest point of a top person's body cannot
exceed approximately twelve inches.
d. The top person cannot perform any skill (twist, toe touch,
ball-up, etc.) during the toss. This rule does not apply to a
"Quick Toss", which can perform skills on the way up.
e. The top person cannot travel over or under another person.
f. The top person cannot be caught in a prone position.
g . The top person may not land in a basket toss loading posi-
tion from a toss.
G. Tumbling and Jumps
1. Dive rolls are prohibited.
2. Flips greater than one rotation are prohibited.
3 . Twists greater than one rotation are prohibited.
4 . A forward three-quarter Flip to the seat or knees is prohibited.
5. Participants may not perform aerial tumbling or rebound over an
individual or prop. (Cartwheels, rolls and walkovers are allowed.)
6 . Participants may not land in a partner stunt or in a catching posi-
tion from an aerial tumbling skill. (Example : A back Flip from a
tumbling pass into a cradle is prohibited, however, rebounding
from a back handspring into a cradle is allowed.)
7. Landings for all jumps must bear weight on at least one foot. {Ex-
ample : A toe touch jump or kick to a hurdler position, to the seat,
knees, or landing with both feet back, or to a push-up position are
prohibited.)
8. Knee drops are prohibited.
9. Any type of hurdler position or the position with both feet back {sit-
ting, landing or lying) is prohibited with the exception of a "Z" sit.
10. Airborne drops to a prone position on the performing sur-
face are illegal. (Examples: A back Flip or a jump landing in a
pushup position is illegal. A handspring to a pushup position is
legal as it is not airborne prior to the prone landing.)
H. Specific Basketball/Indoor Court Restrictions
The following skills are prohibited at basketball and other athletic con-
tests conducted on courts, except where the area is free of obstruc-
tions and non-cheer personnel, and all skills are performed on a
matted surface.
1. Basket tosses, elevator/sponge tosses and other similar
multi-based tosses are prohibited.
2. Partner stunts in which the base uses only one arm to support the
top person are prohibited.
3. Released twists into or from stunts or pyramids are prohibited.
4. Inversions in partner stunts and pyramids are prohibited. The ex-
ceptions to this rule are the following :
a. Inversions that begin on the ground and go to an upright posi -
tion where the top person is in constant contact with a base or
spotter are allowed.
5. Twisting tumbling skills (Arabians, full twisting layouts, etc.) are
prohibited. The exception to this rule is the following :
a. Cartwheels, roundoffs and aerial cartwheels are allowed.
I. Additional Restrictions for Youth I Rec, Elemen-
tary, Middle and Junior High School
The following restrictions for youth / rec, elementary, middle school
and junior high teams are in addition to the above rules for high
school teams:
1. Basket tosses, elevator tosses and similar multi-based tosses are
prohibited.
2. The total number of twists in a dismount from stunts cannot be
greater than one and one quarter rotation .
Copies of these guidelines should be distributed to all squad members
and any administrators involved with the cheerleading program. All
guidelines should be understood and accepted by all parties involved
in the cheerleading program including advisors, coaches, assistants,
squad members, parents, and administrators.
The above safety guidelines are general in nature and are not in-
tended to cover all circumstances. All cheerleading gymnastics includ-
ing tumbling, partner stunts, pyramids and jumps should be carefully
reviewed and supervised by a qualified adult advisor or coach .
Cheerleading jumps, gymnastics and stunts may involve height and in-
version of the body and there is an inherent risk of injury involved
with any athletic activity. While the use of these guidelines in coordi-
nation with the AACCA Safety Course will help minimize the risk of in-
jury, the American Association of Cheerleading Coaches and
Administrators makes no warranties or representations, either ex-
pressed or implied, that the above guidelines will prevent injuries to
individual participants.
For more information, visit AACCA.org . If you have questions regard-
ing a specific rule, contact us at 800-533-6583 .
FOR ANY CLARIFICATION OR INTERPRETATION OF THE ABOVE SAFETY GUIDELINES PLEASE
CALL BILL AHERN AT 1-888-CHEERUCA OR EMAIL BAHERN@UCA.COM
We have reviewed the Rules and Regulations with our entire team and we accept the Rules and Regulations as a fair and integral part
of the rules of the competition and agree to adhere to the rules, policies and procedures contained herein.
School/Team Name Date
City, State Advisor ' s Signature
Division - Junior High, Small Varsity, etc. Captain' s Signature
New!! 2012 World School
Cheerleading Championships
General Requirements
Only teams competing in the 2012 National High School Cheerleading Championship are
eligible to compete in the World School Cheerleading Championships
No Extra Cost to compete
Competition will take place during the 2012 National High School Cheerleading Championships
at the Walt Disney World ESPN Wide World of Sports Jostens Center and HP Field House
at the Walt Disney World Resort- Sunday February 12, 2012
All United States teams must pre-register (please see enclosed form)
NHSCC score sheets, rules and regulations will also be used for the World School Cheerleading
Championships for easy participation
Over 30 Non-USA Cheer Teams from 10 nations have committed to compete in the event
Teams Eligible to compete
All teams competing in the 2012 Junior High, Small Coed and Large Coed Divisions are
automatically eligible based on NHSCC schedule (please see World School Cheerleading
Championships divisions below)
All teams competing in the 2012 Small Varsity, Medium Varsity, Large Varsity, and
Super Varsity Divisions must have placed in the top 10 at the 2011 NHSCC to be eligible
{via 2012 NHSCC schedule); adjustments may be made based on participation level/team
division changes from 2011
All 2012 Eligible Teams can participate in any of the following
World School Cheerleading Championships Divisions:
Junior Recreational - 14 years and younger, 5-35 members
Senior Recreational - 15 years and older, 5-35 members
Junior School Division - 5-25 members or less
Small Varsity - 5- 12 female members
Medium Varsity -13-16 female members
Large Varsity -17-20 female members
Super Varsity -21-30 female members
Small Coed Team Cheer - 5 -20 members ( 4 males or less)
Large Coed Team Cheer - 5- 20 members (5 males or more)
World School Cheerleading Championships Awards:
Division placements will be awarded each World School Cheerleading Championships division
World nation rankings will also be awarded to top teams
REGISTRATION FORM
2012 WORLD SCHOOL CHEERLEADING CHAMPIONSHIPS
THIS FORM IS DUE EVEN IF YOU ARE NOT ATIENDING ON THE WSCC TRAVEL PACKAGE.
PLEASE COMPLETE IN BOTH ADDRESSES (PRINT DR TYPE IN BLUE DR BLACK INK)
0 PLEASE SEND INFO TO OUR SCHOOL ADDRESS BELOW:
PLEASE CHCK ONE:
0 Junior Recreational
School/T earn Nome
Contact Person
School /T earn Address
City, State, Zip
School Phone School Fax
Quali fying Competition Date
0 PLEASE SEND INFO TO THE HOME ADDRESS BELOW:
Home Address
Home City, Stole, Zip
I I I
Work Phone Home Phone Cell Phone
E-mail Address
LIST YOUR FEDEX SHIPPING ADDRESS BELOW
(NO p_o. BOXES, PLEASE) :
Street Address
City/State/Zip
Daytime Phone Email Address
I I
Cell Phone
14 years and younger,
5-35 members
0 Senior Recreational
15 years and older,
5-35 members
0 Junior School Division
5-25 members or less
0 Small Varsity
5-12 female members
0 Medium Varsity
13-16 female members
0 Large Varsity
0 Super Varsity
0 Small Coed Team Cheer
5 -20 members (4 males or less)
0 Large Coed Team Cheer
5- 20 members (5 males or more)
PLEASE COMPLETE ONLY IF YOU ARE NOT PURCHASING THE TRAVEL PACKAGE!
0 Our team will NOT be attending on the travel package. We will be making our own arrangements. Listed below is information
regarding where we will be staying in Orlando, including a phone number.
Hotel Nome
Nome Registered Under
Hotel Address
2012
Hotel Phone Dote of Check-in
Advisor's Sig no tu re
Number of Advisors Number of Partici pants
COMMUTER
REGISTRATION FEES
For those teams not purchasing the travel package,
there is a $215.00 per person non-refundable or
non-transferable registration fee (advisors included).
This fee includes o three day Walt Disney
PARK-HOPPER Pass l o be used for two days of
competition at Disney's Hollywood Studios
and/or ESPN Wide World of Sports
Complex, and one additional day to visit a
Walt Disney Park of your choice.
(This fee include the C hampionship Cele-
bration Party or transportation to porks.)
0 The Celebration Party is an additional $35
per person (this does not include transportation).
__ Number of li1kels I would like lo punhase.
0 We would like to upgrade our tickets lo four
day PARK-HOPPER Passes for an additional
$30 per person.
__ Number of lidiels I would like lo upgrade.
If your qualifying competition takes
place close to your deadline, we
suggest you have all paperwork
ready to mail immediately after your
competition. Our hotels fill quickly
and sometimes fill prior to the
dead.line date.
place in October or November, this
packet & deposit are due
December 2, 2011.
place in December, this packet and
HOTELS MAY FILL UP PRIOR TO
PUBLISHED DEADLINES.
BALANCE OF PAYMENT
IS DUE
JANUARY 5, 2012!
If you have family members flying separately from the teams, we suggest they register with
us se aratel in order to receive their tickets, nametags, etc. when the arrive.
*** FRIENDS AND FAMILY REGISTRATION INFORMATION ***
THE NEXT TWO PAGES ARE FOR FRIENDS & FAMILY REGISTERING
SEPARATELY FROM THE TEAM.
Tear out the next three pages and give them to friends and family who would like
to attend the High School Cheerleading Championship on our Travel Package!
Please feel free to make copies of these pages!
ATTN: NHSCC
P.O. BOX 752790
MEMPHIS, TN 38175
FEDEX ADDRESS:
67 45 LENOX CENTER COURT,
SUITE 300
MEMPHIS, TN 38115
REGISTRATION & $ 100 PER PERSON DEPOSIT ARE DUE.
If your qualifying competition takes place in October or November, your deadline for deposit is
December 1 , 2011
If your qualifying competition takes place in December, your deadline for deposit is
December 15, 2011.
BALANCE OF PAYMENT IS DUE BY January 5, 2012.
Reservations received after deadline will be accepted based on hotel availability.
FRIENDS AND FAMILY REGISTRATION
2012 HIGH SCHOOL CHEERLEADING CHAMPIONSHIP
UCA encourages Friends and Family to attend NHSCC! We want to offer you the same great travel packages that
teams are offered. We HIGHLY recommend that you set up your own registration by filling out all portions of the front
and back of these forms. Please send only one form per room.
Contact Name (only one contact per invoice - every room on this form will be on the same invoice)
Mailing Address
City, State, Zip

Email Address

School or Youth Rec that you are supporting
FedEx Address
City, State, Zip
)
ROOMING LIST: IMPORTANT: This form must be filled out completely in order for your registration to be accepted. Reservations
will be entered according to the dates below and charged as such. List below names in full of people staying in
either quad (4), triple (3), double (2), or single (1), rooms. In parenthesis, specify one of the following for each
person: (P) =Participant (A)= Advisor (F) =Family/Friend 0 Upgrade to 5 Day Park Hopper
PLEASE NOTE: Rollaway beds are not available. (PLEASE PRINT OR lYPE) !Please color for Upgrades only)
SINGLES (ONE IN EACH ROOM) P/ A/ F Arrival Date OepartDate {{ . SINGLES (ONE IN EACH ROOM) P/ A/ F Arrival Date Depart Date <!/'
1. ( ) ( ) ( )d 1. ( ) ( ) ( )0
1. ( ) ( ) ( ) 0 1. ( ) ( ) ( ) 0
1. ( ) ( ) ( )0
1. ( ) ( ) ( ) 0
2. ( ) ( ) ( )0
2. ( ) ( ) ( )0
1. ) ( ) ( )0
1. ) ( ) ( )0
2. ) ( ) ( )0
) ( ) ( )0 2.
1. ( ) ( ) ( )0
1. ( ) ( ) ( )0
2. ( ) ( ) ( )0
2. ( ) ( ) ( )0
3. ( ) ( ) (
)0 .
3. ( ) ( ) ( )0
4. ( ) ( ) ( )0
AIRPORT TRANSPORTATION
If you need transportation to and from the Orlando International Airport, you must read this information carefully. We will be sending
you a transportation packet of important instructions for setting up your transportation to and from the airport. This packet should arrive
about 4 weeks prior to the event.
* Transportation between Orlando International Airport and the Walt Disney World Resort l/JSOC!/S ND.GICDt' f.In&SS
will be provided by Disney's Magical Express. Attendees utilizing another airport will need
to find alternate transportation.
* Disney's Magical Express provides motorcoach transportation to/from the Walt Disney World
Resort and special luggage delivery service.
* Disney's Magical Express requires a reservation. Each guest must be registered at a Walt Disney
World Resort prior to contacting Disney's Magical Express.
* After registering for the event, each team will be provided with specific details to book their Disney's Magical Express reservation. Reserve
lions need to be completed 14 days prior to arrival. Guests will be asked to provide a mailing address and inbound/outbound flight information.
* Disney's Magical Express will mail Airport Transportation Booklets which include detailed arrival instructions and special luggage tags.
*If your quahfying competition takes place in October or November, this packet and deposit are due December 1, 2011.
*If your quahfying competition takes place in December, this packet and deposit are due December 1 S, 2011.
Balance of payment is due January S, 2012.
)
)
)
)
r
D
J
D
' )'
i
3"
)
0
3
)
....
D
3
J

)
...,
r
0
FRIENDS AND FAMILY REGISTRATION
Schaal/Team Name Cily/Slale
ACCOMMODATIONS DIRECTIONS:
1. Choose the hotel you wish to stay in (Disney's All Star Resort or Disney' s Caribbean Beach Resort)
under the package that you wish to purchase.
2. Choose the type of room you wish to stay in (quad, triple, double or single)
3. Return with a $100.00 (non-refundable or transferable) per person deposit to the NHSCC office.
If your qualifying competition tokes place in October or November, this pocket and deposit ore due December 1, 2011.
If your qualifying competition tokes place in December, this pocket and deposit are due December 1 S, 2011.
HOTELS MAY FILL UP PRIOR TO PUBLISHED DEADLINES.
All Walt Disney Theme Park tickets ore valid January 30 - February 18, 2012.
OFDUR NIGHTS PLEASECHOOSEONE: oTWD NIGHTS PLEASECHOOSEONE:
Travel package price for the four nights of:
PLEASE CHOOSE ONE:
February 9 (check-in) through February 13 (check-out) indudes:
February 10 (check-in) through February 14 (check-out) or
Four nights and five days hotel accommodations
Special "UCA Night" at the Magic Pork*
Four day Walt Disney PARK-HOPPER Poss
Three days admission into ESPN Wide World of Complex
Two counter service meal vouchers !One entree, dessert and beverage per voucher-01 designated
Theme Pork dining locations. lunch or D'nner ONLY.)
Tronsporlolion lo all NHSCC events
Au. STAR RESORT CARIBBEAN RESORT
Quad (4 per room) .......................... $477.00 per person .................... $547.00 per person
Single (1 per room) ............. ............. $849.00 per person ............. ..... $1037.00 per person
(NONE OF THE ABOVE PRICES INCLUDE AIRFARE.}
0 THREE NIGHTS PLEASE CHOOSE ONE:
The travel package price for the three nights of February 10 (check-in) through
Three nights and four days hotel accommodations
!Orl ando lnlernolionol Airport ONLY)
Four day Walt Disney PARK-HOPPER Poss
Three days admission into ESPN Wide World of Complex
Two counter service meal vouchers !One entree, dessert and beverage per voucher-at designated
Theme Pork d"ning locot1ons. lunch or Dinner ONLY.)
Transportation lo all N HSCC events
All taxes and gratuiti es
ALL STAR RESORT CABJIBEAN RESORT
Double (2 per room) ................... ..... $546.00 per person .................... $617.00 per person
Single (1 per room) ........................ .. $739.00 per person .................... $861.00 per person
* You will need to use your WDW Park Hopper Pass in order to attend this event!
The travel package price for the two nights of February 10 (check-in) through
February 12 (check-out) indudes:
Two nights and three days hotel occommodotions
!Orlando lnlernotionol Airport ONLY)
Three day Walt Disney Poss
Three days into ESPN Wide World of Sports Complex
One counter service meal voucher !One enlree, dessert and beverage per voucher-al designated
Theme Pork dining locations. Lunch or Dinner ONLY.)
Tronsportotion to all NHSCC events
Triple (3 per room) ........ .................. $418.00 per person .................... $475.00 per person
Double (2 per room) ........................ $459.00 per person .................... $531 .00 per person
Single (1 per room) ........ .................. $591.00 per person .................... $704.00 per person
EXTRA NIGHTS
(ONLY WITH THE FOUR NIGHT TRAVEL PACKAGE!)
PLEASE CHOOSE ONE:
I would like to stay an extra night on (check ALL that apply):
Wednesday Thursday Tuesday
Feb.8,2012 Feb.9,2012 Feb. 14,2012
Optional Extra Nights !Wednesday, February 8, Thursday, February 9 or T uesdoy,
February 14). Since the hotel hos very limited space ovorloble for these nights,
reservations for the extra nights will be accepted on o first come-first served bosis. Disregard this
section if you pion lo stay the regular four nights end five doys.
All raams . ............ . .... . . . $119.00 per room ...................... $200.00 per room
(regardless al occupancy)
Commuter Participant Fee: $215
For those porli ciponls not purchasing the ttovel package, there is o $215 per par ti cipant registration
fee. This fee incl udes:
Three Doy Walt Disney PARK-HOPPER Poss
All reg1slrolion fees for the NHSCC
PLEASE MAKE CHECKS PAYABLE TD NHSCC!
MAILING ADDRESS:
NHSCC P.O. Box 752790 Memphis, TN 38175-2790
DR TD FED EX YOUR REGISTRATION:
67 45 Lenox Center Court Suite 300, Mem his, TN 38115
CREDIT CARD PAYMENT:
If any family members wish to charge their deposit or balance of payment on a credit card,
we accept VISA, MasterCard, Discover or American Express. Below list the person wish-
ing to charge, their credit card number, expiration date and amount to be charged along
with their signature. Please send this information along with your registration.
(One form per family group.)
Schoof/Rec. Team City/State Invoice Contact
CREDIT CARD TYPE: o VISA o MC o AMEX o DISC Exp. Date:_/_/_
Total Amount Charged: $ _____ _
AccountNumber: DODD DODD DODD DODD
0 Deposit or 0 Balance of Payment*
Name (Print) Signature
Billing Address
Daytime Telephone Number Cell Phone Number
City, State Zip
Email Address
If this credit card payment is not for your entire group, please list
person(s} and amounts to be paid with this credit card.
Person(s) Amount
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
*Please complete this form for each charge (i .e. charge your deposit
in October and then complete another charge form in
December to charge your balance).
Balance of payment due by January 5, 2012.
CANCELLATION
POLICY:
For cancellations received on or before
January 5, 2012, all monies will be
refunded with the exception of the one
hundred dollars ($100.00) per person
deposit. For cancellations between
January 6, 2012 and January 11,
2012, an additional $100.00 per
person penalty will apply to cover
hotel and entertainment guarantees.
Cancellations received after January
11, 2012 will result in a FULL FORFEI-
TURE of all monies paid. All cancella-
tions must be in writing to the National
High School Cheerleading Champi-
onship. We will not accept cancella-
tions by phone. Deposits from
cancellations cannot be applied to-
ward your balance.
I have read the cancellation policy
and understand and accept its con-
tents. I have also advised all partici-
pants, parents and chaperones of my
group of this cancellation policy.
Main Contact Signature
Date
Each adult traveling on the
travel package and each
participant's parent must sign
below. "We have read the
cancellation policy and un-
derstand and accept its con-
tents." Your application will
not be entered without all
signatures.
Watch these Disney Travel Tips to find everything
you need to make the most of your Nationals
experience at the Walt Disney World Resort.
We make It easy for your team and family to plan the trip of a lifetime to the UCA/UDA National
Championship at the Walt Disney World Resort!
Book your travel through UCA/UOA
Get a step-by-step explanation of what you need to
know about Disney's Magical Express, UCA's airport
transportation partner.
Get inside info on what to do at Epcot, Magic
Kingdom Park, and Disney's Hollywood Studios.
Learn how to get the most out of your park passes
by taking advantage of extended hours and Fast Passes.
And much, much more!
Watch them now on
uca. varsity. com/traveltips!
EXHIBIT 5
Rocky Point Cheerleading/Stunt Clinic
Home of the National Cheerleading Champions
Cheer clinic open to girls in grades K - 3 $20
Cheer/Stunt clinic open to girls in grades 4 - 8 $25
Where: Joseph A. Edgar Gym
525 Route 25A, Rocky Point
When: Saturday, April 2nd
Time: 9:00 a.m. - 12:00 p.m.
All campers will be instructed by Rocky Point J.V. and Varsity cheerleaders.
They will be taught the fundamentals of cheerleading along with assorted cheers, chants and
dances. The stunt clinic will focus on the proper techniques of stunting.
an.d S..e,e. QUr VE:ry QWn UCA. NQ:tfQncd varsity Ch.eerie.a.ding Ch<Jn:tpiQnS
See. the routine that brqu9ht n.atio.n.QI hQm.e. tQ long Island!
If you are interested, please detach and fill out the form below.
Include your check for $20/$25 made out to LIVCCC and bring with you or send to:
RP Cheer 6 Pigeon Road Rocky Point, NY 11778
If yon prefer, place payment and slip in an envelope marked Cheer Clinic and have your child
return it to her teacher by Wedne8day, March 30th
Any questions - contact Janet@ 255-6636

RP cheer/stunt clinic - payment due by Wednesday, March 30th
Child's name grade
Emergency contact phone# ____________________ _
Parent signature ________________________ _
E-mail address
-------------------- ------
EXHIBIT 6

ft *
f:.t {;z

*

.. -"'-
M

.A. -"-
****l-losted By Rocky PoiHt Cheerleading****
*
Cost $25
I< thru 6th grade
Friday, May 17, 2013
5:00- &1:00 poM.,
Rocky PoiHt Middle School Gym
Complete the form below and return to
544 Route 25A Rocky Point.
Checks made payable to LIVCCC.
Questions? Email ajohannesen@optonline.net
Text/ call 6Sl-fSS-4J6q
i.'r

.-!
*
{." Child's Hame r':r

f! Child's grade 1-r

ParnHt cnf ( #

Parent e .. mail
.J\- J ...
w

ft
*

**PRESENTED BY THE ROCKY POINT CHEERLEADERS**
CLINIC DATE PLACE
Sept. 21, 2012 RPMS
Oct. 4, 2012 RPMS
Nov. 2, 2012 RPMS
Nov. 30, 2012 JAE
Dec. 28, 2012 JAE
COST: $25 PER CLINIC*
TIME
5PM-8PM
5PM-8PM
5PM-8PM
5PM-8PM
lOAM-lPM
*Register for ANY 3or more and receive $5 discount per clinic
-Circle the date( s) you wish to attend
-Make checks payable to LIVCCC
-Return payment and form to child's teacher or
544 Route 25A
Rocky Point, New York 11778
Child Name:
-----------------
Chi Id Grade:
-----------------
Parent Name:
----------------
Parent Cell: ________________ _
Parent Email:
-----------------
QUESTIONS: Call Annmarie @631-833-4169; email ajohannesen@optonline.net
ri
_,
I.;
EXHIBIT 7
Rocky Point School District
6/ 25/ 2008 RP Cheerleaders
10/22/2008 RP Boost er (Cheer)
2/ 24/ 2009
Rocky Point Varisty + JV
Cheerleadinq
2/ 24/ 2009
Rocky Point
Cheerleadino
3/ 11/ 2009 Cheerleading
5/ 8/ 2009 RP Cheer
5/ 15/ 2009 RP Cheer
5/ 20/ 2009
Rocky Point Community
Ed
6/ 2/ 2009 RP Cheerleading
7/ 11/ 2009
Rocky Point
Cheerleaders
7/ 11/2009
Rocky Point
Cheerleaders
12/ 2/ 2009 RP Cheer
6/ 4/ 2010 RP Cheer
6/ 18/ 2010 RP Cheer
5/ 5/ 2011 MS Cheer
3/ 6/ 2011
Rocky Point
Cheerleadina
4/ 28/ 2011
Rocky Point
Cheerleadino
8/ 24/ 2011
Rocky Point
Cheerleadina
8/ 24/ 2011
Rocky Point
Cheerleadino
9/ 9/ 2011 LIVCCC- RP Cheer
10/ 4/ 2011
Rocky Point
Cheerleadino
Yellow= Cheerleading Activities
Applications for Use of School Facilities
Season's Daily (JV & Varsity) Practice (Fall + Winter) Anna Spallina, Melissa Hayden
Season's Daily (JV & Varsity) Practice (Fall) Anna Spallina, Melissa Hayden
Clinic Fundraiser (October) Anna Spallina, Donna Collier, Melissa Hayden
Clinic Fundraiser (November) Coach Spallina, Coach Collier
Clinic Fundraiser (December) Coach Spallina, Coach Hayden, Coach Collier
Clinic Fundraiser (January) A. Spallina, D. Collier, M. Hayden
Breast Cancer Walk Anna Spallina
Summer UCA Camp
Varsity Coach - Anna Spallina & JV Coach -
Melissa Havden
Football Cheerleading, Varsity Practices Anna Spallina
V-ROC UCA Camp for Rocky Point Varsity Team RP Cheerleaders, A. Spallina
Tryouts for Middle School Donna Collier
RP MS Summer Cheer Camp Donna Collier
JV Cheerleading Camp Melissa Hayden
Cheerleading Ronnie Gilbert, Anna Spallina
LICCA Competition at HS & MS RP Cheerleaders, Spallina, Hayden, Collier
LICCA Competition for JV & Varsity Cheerleaders Anna Spallina, Melissa Hayden, Donna Collier
LICCA Competition for JV & Varsity Cheerleaders Anna Spallina, Donna Collier, Melissa Hayden
Cheerleading Clinic for K-8th grade Donna Collier
MS Cheer Camp Donna Collier
Cheer Camp Donna Collier
Meet with Varsity Cheerleaders
MS Cheer Tryouts Donna Collier
Fund raising for Rocky Point Cheerleaders Anna Spallina, Donna Collier, Lenee Passiglia
For Workshops Cheerleading tryouts Anna Spallina
Varsity & JV Cheer Camp Anna Spallina, Lenee Passiglia
Not noted on application Anna Spallina, Lenee Passiglia
Fund raiser for Nationals (Note on application states
Anna Spallina, Donna Collier, Lenee Passiglia
"Chanaed to 9/ 28/ 11 as oer Amv'"
Fundraiser for Nationals Anna Spallina, Donna Collier, Lenee Passiglia
Sale of clothing, snacks, etc. for fundraising Ann Marie Johannesen
Page 1of2
Source:
Application for Use of School Facilities
8/ 25/ 2008 11/ 24/ 2008
8/ 25/ 2008 11/24/ 2008 60
10/ 10/ 2008 10/ 17/ 2008 100
11/ 7/ 2008 11/19/ 2008 100
12/ 1/2008 12/17/2008 100
1/ 12/ 2009 1/26/ 2009 100
11/1/2008 11/1/2008
7/ 6/ 2009 8/ 30/ 2009 I 50
9/1/2009 11/25/ 2009 50
7/6/ 2009 7/ 10/ 2009 40
6/ 8/ 2009 6/ 10/ 2009 100
7/ 20/ 2009 7/ 23/ 2009 30
6/ 29/ 2009 7/3/2009 30
7/ 13/ 2009 7/ 16/ 2009 50
12/12/2009 12/ 12/ 2009
12/ 12/ 2009 12/ 12/ 2009
12/ 12/ 2009 12/12/2009
12/ 28/ 2009 12/ 28/ 2009 75
8/ 16/ 2010 8/ 18/2010 40
8/ 29/ 2010 8/ 31/2010 75
6/ 25/ 2010 6/ 25/ 2010 25
6/ 3/ 2011 6/ 8/ 2011 75
4/ 2/ 2011 4/ 2/ 2011 100
4/ 26/ 2011 4/ 28/ 2011 100
6/ 27/ 2011 7/ 1/2011 100
7/13/ 2011 8/31/2011 60
9/ 30/ 2011 9/ 30/ 2011
10/ 21/2011 10/ 21/2011
I
100
9/ 24/ 2011 9/ 24/ 2011
I
10
9/ 28/ 2011 9/ 28/2011
10/ 25/ 2011 10/ 25/ 2011 I 100
9/ 13/2011 Cheerleading
11/22/ 2011 Island Xtreme Fast
3/ 28/2012 Cheerleading
Yellow = Cheerl eading Activities
Fundraiser for Nationals
Applications for Use of School Facilities
A. Spallina, D. Collier, L. Passiglia
Instruct Rocky Point Cheerleaders Meli ssa Torres
JV & Varsity Cheer Camp Anna Spallina & Lenee Passiglia
Page 2 of 2
Source:
Application for Use of School Facilit ies
11/10/ 2011 11/ 10/ 2011 100
11/23/ 2011 1/10/ 2012 24-28
6/ 25/ 2012 6/ 29/ 2012 90
:FOI!fT :l>ISTilil!T
FO::B.. "USE OF F
2007- 2008 SCHOOL YEAR
Phone # KO-/ -{)1.f 5 ,7

Room Requested: J)
School Requested:
o Frank J. Carasiti
(K-2)

(3-5)
o Middle School
(6-8)
o High School
(9-12)
___ Cafeteria
___ Field _______ _
Other
--- ------
Hours Sta
ertificate Attached
No requests will be approved without a certificate of insurance, even if one is
Roster must be attached!
AED Trained lndividua
.-----
HifJ.;_ (Please read back of form)
__
oq 5Bi<Jn dV + Vrus"rfy f-rtt ms.
*Classroom rental fee is $40 per session (Evenings & Weekends)*
*G mnasium Cafeteria & Auditorium rental fee is $40 er hour eekends *
(Make checks payable to Rocky Point Schools)
i Approved Date f
lp ___ /7 J D Disapil!?ate __
<Ya I - CY-f S'J !, School Official
Telephone # , PiJJ..J
c: Applicant Building Principal
I
I
I
I
I
I
Title
IlOC!KY FOIIT 8t!HOOL IST:B..IC!T
FOB. "11SE OF F A..C!ILITIES
2007- ZOOS SCHOOL YEAR
Read the "Guidelines for the Use q/School District Facilities'' on the back of this form.
Name of Organization e-r R L f ADER s Date of Application 0 -;x s of?
Description of Activity (5-e05on S Da ii V )(f a_j f )
Designated Supervisor of Activity ,A' 0pLl l i VlOJ /Me I 1 ssa (}
Address /2 l1)e.s/-d7eokr l>r/u(1 eP Phone# g a/- aijsl-
School Requested: Room Requested:
___ Classroom
;X:. Gymnasium
Auditorium
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
'lit' Middle School
"\ (6-8)
o High School
(9-12)
---
___ Cafeteria
5o:v1 ettfYl.t' 6 Field _,_;>C _______ _
___ Other ____ _
Date Start m-tlf-0 Date End //- 1-0 8 Hours Start a Lf 5 End 6 p!T)
No. in Attendance &, 0 Insurance Certificate Attached __
No requests will be approved witlzoul a certificate of illsurance, even if one is already on file with the district!
Roster must be attached! . _/
. . . CtxLCJJ /fitj_{J f)
AED Tramed Ind1v1dual CoocH 6DA-Ll!NA(Please read back of form)
I
Purpose (Be Specific): <!: v '/= Var s'1 ttj A&:h c e. w \' &uS0(\
*Gymnasium, Cafeteria & Auditorium rental fee is $40 per hour (Weekends)*
I have reviewed the guidelines pertaining to the
use f District and agree to comply f1,1.lly
Telephone#
r----------------------------------------
I
I
I
I
I
I
I
I
Use Only
9" Approved Date Ff fa
D
Auth.JU?ed School Official
Title
Jl.Ollitt.Y :FOI1'T 8CHOOJ:. l>ISTilI_,T
:FOB. VSE O:E St:HOOL FAC!II..iITIES
2007- ZOOS SCHOOL YEAR
Read the "Guidelines for the Use o.f Sclwol District F actfities '' on the back of this form.
Name of Organization Rf? CJARJ2 LfrDI rUb Date of Application <Q- -O- {) 8
Description of Activity Cl 1 0 \ C.., ( Qab_p!o-_\.!-)..!-______ _
DesigutedSnprvisorof /f):xma. (oilier:
l\::tW &4-MJPhone# '6GJ.\-QL/5'J
a Frank J. Carasiti Classroom
(K-2) X.. Gymnasium 8-Tf\ Bl ES + 5cho. \ r.5
a Joseph A. Edgar Auditorium
(3-5) Cafeteria
O Middle School Field ______
(6-8)
cc
-t7\C2 :C 'J(.. High School
- I VWL..f\ (9-12) I.
f'R l tJA\J the q...fR I DR-U TttE Jr; +-h
Date Stari/C)-)D-0 .J Date End l c/-11-0 r;;: I Hours Start End IQ em
No. in Attendance I 00 Insurance Certificate Attached__ J
No re.qllests will be apprtived without a certificate of ms11.rance, eJ1en if one i.<; already on file with the db. rictl
(Please read back of forin)
u nd td.LS eC
*Classroom rental fee is $40 per session mvenings & Weekends)*
*Gymnasium. Cafeteria & Auditorium rental fee is $40 per hour (Weekends)*
(M:ake checks payable to Rocky Point Schools
r-------- -------------------------------
j istrict Use Only al J _ J
! Approved Date-1Jc3f2/ ll{
I
I
I
I
I D atec __ _.,:_
Telephone #
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
School Official [
Title
t: AppliCAnt Building Principal
I
I
:llOl!KY 8t!HOOL :l>IST:R.Il!T
FO:R. "USE OF 81!HOOL F Al!II..ITI:ES
Read the ' .idelinesfor the Use of School District Facilities " on the back of this form.
Name ofOrganizatio rt Date of Application
Description of Activity CJ 1 'o \ G 0 L) E rn b E \)
Designated Supervisor of Activity . c ou..c.h \ \, i\Q r CoQ,.(_ h __ Gt1 ie.r
Address 1';11A).Scbe:;-1ex Dnue.. e-P Phone# -OL-[ s?-
_ __ Classroom
o Frank J. Carasiti
(K-2)
l{ Joseph A. Edgar
(3-5)
o Middle School
(6-8)
0 ID "'/:= Gymnasium
___ Auditorium
___ Cafeteria
___ Field _______ _
___ Other _____ _
o High SJhool
NoVErnBER c
9
-
12
). /
felDPrV 11-7-03 rt i/-/9-08
Date Startf ! \ -1 - Q Date End I { - i 9 -08 Hours Start S Pm End / 0 Pfl)
No. in Attendance j 00 Insurance Certificate Attached
No requests will be approved without a certificate of insurance, even if one is alrea,{v on file with the district!
Coo...c.-\J Co\\ \.,.:X-- .
. . '
AED Trained lndividualC()()L}\ CW..\\\. oD-J (Please read back of form)
c..ca_u" e.rr
Purpose (Be Specific):

0 \n\ c.- \
*Gvmnasium, Cafeteria & Auditorium rental fee is $40 per hour (Weekends)*
use of strict Facilities and agree to comply fQ.lly
Telephone#
r----------------------------------------
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
(District Use Only
[!] Approved Date ___ _
Title
.:ROCKY :FOI!iT SCHOOL
APPLICATION FO:B. "USE OF 81!HOOL FACILITIES
Read the ''Guidelines for the Use of School District Facilities" on the back of this form.
Name of Organization .g_Q CH ESRLEfJDf f06 Date of Application -drS-02
Description of Activity Li in \. G (D ELfJY\Bf AJ
Designated Supervisor of Spll \1 co_f oCJ<Cli {oa ( h {fi/ /1;
Address e I Phone# "I -OLJ:S=7-
o Frank J. Carasiti Classroom
(K-2) 010 X. Gymnasium
Joseph A. Edgar Auditorium
(3-5) Cafeteria
D Middle School Field _______ _
(6-8) Other ____ _
D High Sc7ol
(9-12) . I
Decemb3r-id-.-J.-og -t,.-og
Date Start Date End Hours Start tj AO End I Q-PfYL
No. in Attendance ) C(\ Insurance Certificate Attached __
No requests will be approved without a certificate of insurance, even if one is already on file with the district!
(Please read back of form)
Coc:LC.h (b\l\e r
AED Trained Individual CoO-L\) ;:ca_\
C OQCJ{ tt f\\\j::tV
------------.-----------------
CJloi <- fund raJ;::eK:
*Classroom rental fee is $40 per sessiOn (Evenings & Weekends)*
*Gymnasium, Cafeteria & Auditorium rental fee is $40 per hour (Weekends)*
use of District Facili es and to comply fQ.lly
A plicant' s 1gna
/Ji wes-kJJes/er ])rive
Applicant's Address f\ q N y { ( 7 7 tfS
xa 1-01:-f,!:) 7=
Telephone#
r----------------------------------------
District Use Only ? /.., .. / ,.,..

D Date
----
Auth rized School Official
M
Title
::ll..Ol!KY :FOiliT 81!HOOL :l>IST::B..Il!T /
A..FPLil!A TIOlf FO::B.. -.:TSE OF 81!HOOL F A..t!ILITIES
Read the "Guidelines for the Use of School District Facilities" on the back ofthfsform.
Name of Organization RQ CH[Lf"Pr.D/JJ 0 Date of Application fo-;J.S-()8
Description of Activity Ci I bC (:SM-JU ft;R Y. ) .
Designated Supervisor of Activity A I spau1 rJ &) :12 (o [ I 1 er' fY\ , H Ayele b
I I
Address iavJeskheskx-12c e, P. Ut/ Phone#
I
--..,,. Classroom
D { D .X. Gymnasium
Auditorium
o Frank J. Carasiti
(K-2)
Joseph A. Edgar
(3-5)
o Middle School
(6-8)
o High School
---
___ Cafeteria
___ Field _______ _
___ Other ____ _
.- _ __s9-12) . I
J
A-nmrLi . 1 .
' DatE! St rJ: i 1- 0 Cf Date End / -Of,- Q 9 Hours Start .3: ?i) End / 0 tJYI
No. en ce J Oc) Insurance Certificate Attached
No requests will be approved without a certificate of insurance, even if one is already on file witlz the district!
coo..cJ, Co c { 1-e_. r
AED Trained Individual c OClLh L1' naJ (Please read back of form)
Ct>CLCJi ttoJ.Jdf' r
Purpose (Be Specific): (

CJ; l'J t G FundroJ:C
*Gymnasium, Cafeteria & Auditorium rental fee is $40 per hour (Weekends) *
:--;:-------
: stnct Use Only c:' /l'J()/'1 v
i Approved
_-_,__ (J_,_y1!71 ( D DisaiE Date __
District Fa ilities and agree to comply fg.lly
Telephone#
l School Official
I
: Title
I
I
I
I
4F I> :FOI\.. "USE OF S!HOOI.. F At!II..I'T---;_.ES
d OC
T 2 L - - - -
Read the "en the Use of School District Facilities " on the back of this form.
Name of Organization f1L . of Application _____ -;--
Description of Activity ST Car1 l f>G LUo.2 K
Designated Supervisor of Activity f'tA1NQ__, _ ._._ //
Address 7 ) f?_ I m?J Phone# d
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
o Middle School
--- School
(9-12)
Date Start _LO '. {)Q Date End /.;) .SO
Room Requested:
___ Classroom
___ Gymnasium
Auditorium
Cafeteria -,/ cJ<
__ Field /l_(J_
Other
-------
/I} joy ) I/ }6y
Hours Start End
---
in Attendance ___ Insurance Certificate Attached lb'
No requests will be approved without of insurance. See back of form
AED Trained Individual (Optional) ____________ (Please read of form)
Cbr_tLLefJdet(J 70 Wo.JL ._JSJ_fa,sc _/JJ(JYl.fc!f__
f, JJ 7 .
.. - . L . - -- - ------------------- ---- - ---- - -------- . - ------- ---
u c of District Facilities and agree to comply fully
cJ- f t.
i\pplicant's /\ddn.:ss
G'J!- 2s-s--us& /f/M ?:eiB
-e.l"pho,.,i.z._ 2J--</
,---L--- -- --- --- ------------ --- --- ---------
I
I '
: stnct Use Only
! Approved Date@flef
I ilk ,4.t:J
\' ( " " ' ' >I ' ' 1dd!f!'
1
' <II I
l h11ldu11! i lt ,,ti ( 11 ... 1t1d1;111 " rt ttrll \
1t11\tnr'"' Clffirr (rnu"l ;.1llrut1 1ni.11rnnrr trr11ftr:ltr1 U11tltl1fl l! .. .'\. <. r 11 t11t1 f..
:ll..O()K.Y EOIIT S()HOOL I>IST:R.I()T
APPLIC!ATIOJf FO:R. 'US:E OF S()HOOL FA()ILITIE8
Read ihe "Guidelines for zhe Use of School Disrricr Facilities " on the back of rhisform.
N f 0
. . Rccl<u +b int-.-../
ame 0 rganrzation I rv 'f- _J 'y .
CM[ERLf.AD! tJG;
Description of Activity
5 U mlllf:R UCA CA mp
Designated SupervisAor of Activity .. ,
V0-ts1+-:i CoAC-h- {l/la 5(JC'-l{ ; nCG
.
[)RI UE
p,oc+s.hY. IQRot rJ T ,dNL/ // 77 g
Sc oo eq ueste :
o Frank J. Carasiti
(K-2)
o Joseph A. Ed gar
(3-5)
"!'-.1.idd]e School
(6-8)
High School
(9-12)
Date of Application {) r3i - d.. L/ -O 9
Room Requested:
----,-- Classroom
_ _..X_..__ Gymnasium
Auditorium
---
___ Cafeteria
___ Field _______ _
Other
nl A -ii Am
Date Start 07 / Dt;; Date End'1".=70Hours StartS1ir,l\1 End'1'.) No. in Attendance I:surance
Certificate Aftached ..Plea:j see t:o.cj( 7
Roster mu.st be attached!
AED Trained Individual {.o(J[), l 1' na (Please read of form)
Purpose (Be Specific): f\J t1 UC--A CAcnp q_,, C,
*Classroom rental fee is $40 per session (Evenings & 'Veekends)*
*Gymnasium. Cafeteria & Auditorium rental fee is $40 per hour 0Veekends) *
(1\fake checks payable to Rocky Point Schools)
use of District Fa 'lities and ag e comply fully
/
,,../
;awes.WE2>TA Df2}lJE
Applicant's Address
ga1

Telephone # FA- X - 8 a ) -y I 1-15
Building Head Custodian Security
.-- -------------------------------------
' I
'
District Use Only

Date
----
Aut School Official
Title
Business Office (must attach insurance certificate) Buildings & Grounds
:FOIIT SCHOOL I>ISTAil'T
A..PPLIC'!ATIOI FO:B. USE OF l'HOOL FAl'ILITIES
Read1he "Guidelines for zhe Use of School Disrric1 Facilities " on the back o.frhisform.
,
J - ,, ''2-. - - -
Date of Application OJ - ,;), L-/ -0 9
Name of Orgamza , -" _ --:
Descripti
1
on of lrA
d
_ _.,., l
1 n'- l \ \. 11q\_
Ad.dress,
1
'1 n
\ l u0 e.S-tc-ti es Tf-
0
I:::' v.
RCX::\<-L{ :Po i.7) NC\ 11/r ci
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
. J
(6-8)
High School
(9-12)
Phone B'a l () Lf 5 ?-
Room Requested:
Classroom

.... . .. ., - .. - - --
___ Auditorium
Cafeteria
---
___ i iciu _______ _
Other
O
o /'\/ ;;- ?.5 -- .JcJ . -- 6U _,._ -c.. - rl
Date Start 7-u DateEnd No.inAttendance fnsurance
Certificate Attached
No requests will be approved without a certificate of insu.ran.ce, el>en if one is alread_l' on file with the district!
AED Trained Individual Cl(\( h \'tna. (Please read back of form) ,
Purpose(BeSpecific): K u n ::PrG\CitCc
l _)
*Classroom rental fee is $40 per session (Evenings & 'Veekends)*
*Gymnasium. Cafeteria & Auditorium rental fee is $40 per hour f\Veekends) *
(1\1ake checks payable to Rocky Point Schools)
,---------------------------------------
' I
District Use Only
pi Approved Date ,)__4f1
/_/ Applicantisija:tllre
1 J-weifwes
Applicant's Address
D Disapproved Date ___ _
Official
AO
Telephone# rct lj- 8a / - Li ( lf S-
Title
Building Head Custodian Securit)
.
Business Office (must attach insurance certificate) Buildings & Grounds
05/01/2012 11:15
531-744-1394
PETER WAGENHAUSER
PAGE 03/03

"
B.Ol?KY ROI](T 8t:B:OOL l>I8TJl..ICT
EO& 'V8:E OJ! :J! A.CJ:I..TIE
Rtod RP !Jr>tllvi f>olic:1 32/:llJ- Cori11111111i1y U.w <:f Sd1or1! l;-t.'1i:ili1ic1.s 8,/(1t't' C:11mpfffi11g Tl1is
Name of
CH-EEK lEA'O I
Date of Application:

- . ( ' ' - ... ' .. - -- .
Address of Sponsoring Organization. _________
Phone: '8ci I - Ci H-5 't E-mail: :rs 0 h' ae. rief-
School Rtquested:
a Frank J. Carasiti
(K"2)
Q Joseph A. Edgar
(3-5)
Middle School
(6-8)
Q High School
(9"12)
Date ... 09 Date
Room Rcque..c;ted:
---..- Classroom
--4'Li.- Gymnasium
___ Auditorium
___ Cafeteria
Field ____________ _
Parking Lot. ___ ..,._ ______ _
Kitchen (Requires Additional Fees)
Other (specify). __
Hours Start:8 End: jf!l1.
Appr-oxirnate Number of Individuals in Attendance: 4 () (Attach roster if avalJabJe.
1rrosterisnotava!lab1eexp1a1n:.T hAV. no+- ba.c;l ritmt'::i .'{ef;I will pro,J.flle.
Insurance Certificate Attached: c:J (Check boi to indlcatt 11pproprl11te of insurance Is 1utaehed to U...'le
NQ requt!!its will Ix! uppr01
1
t1<J wit/111111 (1 cert{ficat(! of im;urnnce. <mm if 011e i.s alre'1d..I' ""file witlt llte dl.vtrict!
AEO Trained Individual ,..4,m. tpill! a c0 (Please read back of form)
Purpose (Be Specific): Chore.C, '<'"O{>h fo..l\ Camp
Fee Enclosed:$ NJ A (see BOE policy #3280 to calculate fee due for this C\'ent.)
(Make checks paya le to Rocky Point Schools)
Sy my signature, below1 I certify that Jam au1borized to Act on behalf of the indlvidual(s) .tnd/or organizatfon(s)
listed as the sponsoring orgirnizatlon for the indicated event(s). Furthermore, I certify that I have received a copy,
read, and understand the RPUFSD Board of Education policy #3280, Community Use of School Facilities as well as
the terms and (Onditions listed on the reverse hereof, and agree, on behalf of m If and the sponsoring
organization, to be bound by the. and conditions contained therein.

W ' D Disa.pprov
6 /31 - XO< J -01-J 51
Telephone#
te. ___ _
Au };zed School Official
Title
AppllenI, Building Prlndpiil, Head CaRIPrlfnn, Ser:uriiy, Office (wltll certlftcnct ofln5urtUI,,).
IlOl!KY :POINT 8C::HOOL :l>ISTilIC::T
A.:F:FLIC::A.TION FOil "'I.TSE OF 81!HOOL F A.C::ILITIES
Read /U' l .. FSD Board of Educatwn Polic_i- 3280 - Comm1mi1y ( 1sc o( Sr:hoo/ Facilirics - Hefore Comp/erwg This Applicarro11
Name
t<f c Md
Date of AppliciJoJ't
P9
Description--a.;':Ji
Address of Spooring Organization
Phone:
School Requested:
o Frank J. Carasiti
(K-2)
Room Requested:
Classroom
1/ Gymnasium ,. T L-Lt'\e f T- q - C). : - S:: iXJ ffl?
.
o Joseph A Edgar
(3-5)
School
(6-8)
___ Auditorium
___ Cafeteria
___ Field ____________ _ _
Parking Lot ___________ _
High School
__..-- f:li !i-
;::J u..f\e._ o Cl
Other (specify) L 1 hra ,... '/ - "'Jk "'I< 10 J: qr -
!Op
Date Start: Date End: Hours Start: AM/PM End: AM/PM
----- ---
Approximate Number of Individuals in Attendance: l 0 0 (Attach roster if available.
If roster is not available explain: ____________________________ _
Insurance Certificate Attached: D (Check box to indicate appropriate certificate of insurance is attached to application.)
No requests will be appNJl'ed without a certi icate of ilJsurance, even if one is already 011 file fl'ith the district.'
AED Trained Individual ( I, (Please read back of form) (\
Purpose (Se Specific):--r;;'-fry 6 t1-I- 6!,_'f_ ] tb;yr ack b /uck/Jk -fv:- /l1:)(!jff /'km
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event.) (
By my signature, below, I certify that I am authorized to act on behalf of the individual(s) and/or organization(s)
listed as the sponsoring organization for the indicated event(s). Furthermore, I certify that I have received a copy,
read, and understand the RPUFSD Board-of Education policy #3280, Community Use of School Facilities as well as
the terms and conditions listed on the reverse hereof, and agree, on behalf of myself and the sponsoring
ion, to be te m and contained j-tifstrictUse __
1
__ _______ _
( A : M Approved _ &"'L OJ
s Si nature i
I D
Disapp;;J;:;-
Authorized School Official
Title
c: Applicant, Buildi ng Princi pal, Building Head Custodian, Security, Business Office (with certificate of insurance).
:R.Ol:KY :POillfT S()HOOL I>ISTilI()T
A.:PFLif:ATIOllf FOil "USE OF Sl:HOOL F A()ILITIES
Read l<f'l .FSD !Joard of F:ducatwn Polic:) 32f\{I - (;011un11nil.\ I
1
.1c of School Facihric.1 - lkfore Completlllg This '1pp/ic1111011
Name a.f
i)l l {l,_Q_.(1'
P\ \ . . '.Jl
Description of Activffy
: r r ll
Designated Contact from Sponsoring Organization: __
__ ,_,.,_,_ ... 1""A...t!"' .=..------>.,(==-"fLk-=='

""J ....
1
...,A_u..= o_-1.._,_,,."'-----
op
Address of Sponsoring Organization __ __________________ _
Phone: X / f) \ /) ' E-mail:
f --------------
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
I
(3-5)
Middle School
(6-8)
High School
(9-12)
f'-1crJ 7'
Date Start: -".''\. , \ , 1 )LDate End: .J 1.A.t..i
- I I
Room Requested:
Classroom
Gymnasium
Auditorium
---
--- Cafeteria
___ Field _____________ _
Other (specify) _________ _
Hours Start: q WM End:
---L .. /
Approximate Number of Individuals in ;_(Attach roster if available.
Insurance Certificate Attached: 0 (Check box to indicate appropriate certificate of insurance is attached to application.)

::; fl'ith the district.'
}v,: ,,. s I
Purpose (Be Specific): / / \::) ( C 11 ()Z/)'V'\, .. /!2 d
. . J
Fee Enclosed:$ ,JJ fl (see BOE policy #3280 to calculate fee due for this event.)
(l\1ake checks payablt to Rocky Point Schools) _
organi,zation, to be bound bnthe tzs and. conditions contained
, I t, , , _') _____ _
/; ! /J I ' J !J!l
: ,. u A V,1, .. . U / : Approved Date .r I
AjBl/?t s J:!c/'" ;(t{: :
Lt '/t.. . /. c
ApplicantJ ' I :
f:3 f -c/ Itel , .... / J:/90 3
1
7%<[
Telephone# /
Date _ _ _ _
Aut oSJt/ School Official
Title
c: Applicant, Building Principal, Building Head Custodian, Security, Business Office (with certificate of insurance).
" 1- ---
:R. o t: KY FOIWT I>IST:llif!T
FO:B. "'CTSE OF Sl:!HOOL F Al:!II..ITIES
Read RP UFSD Board of Education Policy 3280 - Community Use of School Facilities - Before Completing This Application
Name of Organization;
cJ11eeY \ea d
IDCJ
Designated Contact from Sponsoring Organization: _____ _________ _ ___ _
Address of Sponsoring Organization ________________ _ _ _______ _
Phone: E-mail:
-------- ------------- ------ --------
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
;(3-5)
Middle School
(6-8)
High School
(9-12)
Date Start: lD \ zq Date End:
Room Requested:
Classroom
Z Gymnasium
_ __ Auditorium
___ Cafeteria
___ Field _____________ _
Parking Lot
------------
Hours End:
3-0
Approximate Number oflndividuals in __ (Attach roster if available.
If roster is not available explain: ____ _________ ___________ ___ _
Insurance Certificate Attached: D (Check box to indicate appropriate certificate of insurance is attached to application. )
AED Trained Individual Me\' ssa \-\opkn (Please read back of form)
Purpose(BeSpecific): ,)y C\rcetimdi1ra carnf)
:..J I
Fee Enclosed:$ -., (see BOE policy #3280 to calculate fee due for this event.)
the terms and conditions listed on the reverse hereof, and agree, on behalf of myself d the sponsoring
organization, to be bound by the terms and conditions contained _ _ _ _ _ _ _____________ _ _ _ _ _ _ _ _ ___ _
, strict Use Only
U Li.0JJo.., b ..\{,CJS di ,Y\J ! Approved Date OJ J4 o !
Applicant's Signature .
2[14 .'l)Urd 9CJCb "B\VD D
Applicant' s Address. SQ U rel I3aJ Lh I\ 18CJ
l.03)- I BLP -15LQ3
Authorized School Official
412 Telephone#
Title
/'
/'
/'/ 1g ,.:;.. (
. ..,
I /"\ . Ii/
:POilfT fi()HOOI.. :l>ISTJi.I()T
A.I>I>I..I()A TIOlf FOB. "USE OF 8()HOOI.. F A()II..ITIES
R,ud Rf'l . .f'Sf) /;uurd of f-.d11ca11vn f ' ofic:1 3180 C I .1, oi Scfwol f-acil11ic.1 fi<Jore ( 'v111ph:1111g l!u.1 A11ril1cwivn
J cs 'J
> r
wS
Address of Sponsoring
Phone: '7 'f t' --<] '--/0/ E-mail: ]J b-'j7- C;.!rll_ Mt
o Frank J. Carasiti Classroom
(K-2) VGymnasium
D Joseph A. Edgar Auditorium
-5) Cafeteria
iddle School Field
--- - ------ - - - -
( 6 -8) Parking Lot _ _ _ _ _ ____ _ _
D High School Kitchen (Requires Additional Fees)
(9-12) Other (specify) _ ________ _
Date k 5 Date Hours Start:?': @AM/PM
Approximate Number of Individuals in Attendance:% (Attach roster if available.
If roster is not available explain: _______________ _ _ _ _ ______ __ _
No requests will he approved without a certificate insurance. eien one is already on f ile with the district.'
AED Trained Individual (Please read back of form)
-----------
----- --- - - - - - - --------- ---- ----
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event.)
IlOCKT FOIIT SCHOOL :l>ISTilICT
FOil "USE OF SCHOOL FACILITIES
Read Nf'l.FSI> Board of F:dun11wn l'o!ic_i 31fi(1 - Com11wni1_1 i Zic of School ranlinc.1 - Befor.: ( omp/etuzg Thi' App/1ccmo11
of Organization:
RP.CHEE.READ 1tJ6
06/0d.}09
Description of Activity _ _ , _
TO tlDLD A LI C.<2..,A LOn1\)et-chon
the M 1 DD L E sc t\-()()L-
Designated Contact from Sponsoring Organization: R.P C.tt LEADE:f\S :5ffiLLi t0 P./ t-l.
Address of Sponsoring Organization I JuJDIL.ME.6tR Pf! lVS. _fu.-Ki Min,. fJ V t_l 77
Phone: 83-i 1 -o YS'1 E-mail: ASP ALctll.)( ex tyf61at,-tziz... L}j_,
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
Room Requested: il..:::.. 1 S
x Classroom . I (\ n ..J_ + \V\ t'
. )( Gymnasium 5 (, ht> 0 5
___ Auditorium
(3-5) M,5, Cafeteria
ta' Middle School Field

( 6 -8) X Parking Lot H"S cf [Y]S
_$. High School i>(' Kitchen (Requires Additional Fees) '5
(9-12) Other (specify) ________ [!\_
JJ:CA -:i crQ1
Date Start:Dt( I a: Date End: Il J Ulj Hours Start:_b_ IPM End:
I --;-"'---
Approximate Number of Individuals in Attendance:_____
If roster is not available explain:
Insurance Certificate Attached: D (Check box to indicate appropriate certificate ofi urance is a ached t
1\'o reqw:sts will hi' appro1>ed a <!limurauce, even if mu' is alre dy onfif l'ith the district.'';?\.
AED Trained Individual j Cc:.:n.Lh e S (Please read back of form)
Purpose (Be Specific): tu rx:I r0:16elr>1< L 1 CCL'- Compe1:t ho11 (( HfEBV f\DI f0E.)
Fee Enclosed:$ N {a (see BOE policy #3280 to calculate fee due for this event.)
(Make checks payabl
1
e to Rocky Point Schools)
Title
FoIJrT
FOB.. VSE OF
Read l?.f'UFSD Board of Fdurnnon Policy 3280 - Co111m1mity ( 'sc of School Faciliries - Bf;{ore ( 'ompletzng This Applicar1011
Name of Organization:
Pri NT C1tEEFZL&WER5
07- 11 -0i
16 tlos+ 8- 1 c. c. P-. C..'J M+> t=T t n OcJ Fr ?i Sy + VRBS I T(./ C HEE/i U=-flJJ.Er>.:S
I
Contact from Sponsoring Organization: ft IV rJ A 59 Prt...C., { lvPr - MP.. L! S\A d f.>-\ ....J DuJ
DOt0 t\JP; C...OL.-L l C.R 1
Address of Sponsoring Organization
Phone: q at -(Y-t5'J
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
'llD Middle School
(6-8)
High School
(9-12)
i j lA L" iT CH E '-; rr p I u F . / ., ' L ! Pt : lv L(
E-mail: r\??fi.<w It 0.5.
Room Requested: . ., , .._. _ N FC-T. :::nJD 4 5.:::>
X. Classroom I L ._f ., _ _ .,.,,ex:: '\
d G . l A , c.-<. "-_,{)VIV\ f' (;:..(>....L,\\t>X
z,, ymnasmm 1
___ Auditorium ( Pt::..R f o iY' Affi RCO\r\ f ./
)( Cafeteria
___ Field ________ _____ _
V Parking Lot ___________ _
/ "
Date Start:JP.L End: 1d.- 13..- .)j Hours Start:_7 __
Approximate Number of Individuals in Attendance: _____ (Attach roster if available.
If roster is not available explain: _ _ _________________________ _
.'Vo will be approPed without a of insurance, even if mu is already 011.file fl'ith the district!
AED Trained lndividual G.,...1.1Ji '.lpJ . .li.Lnq. Hn_uden (Please read back of form)
eocu:.r--. Col L\-er i
Purpose (Be Specific):[(') HC;.<-); 0 LULP. r On -sv f' \'
I : '_
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event.) ' -- --- ----
- , . I
(Make checks payable to Rocky Point Schools) < !
, ' : JUL 1 6 2t0
By my signature, below, I certify that I am authorized to act on behalfofthe individual(s)
listed as the sponsoring organization for the indicated event(s). Furthermore, I certifY that I ha'Ve reCeived-a-copy;---- - -- --
read, and understand the RPUFSD Board of Education policy #3280, Community Jlse of School Facilities as well as
the terms and conditions listed on the reverse hereof, and agree, on behalf of and the sponsOfiiig
organization, to be bound by the terms and conditions contained therein. /
4MAvuJ / --
/Applicant's ?{gndture I) (
1) P.. JB n_;e w4 Yc ;,--( D DisapiWro ve ate
Applicant' s Address N y 17 7 g _

..:. _, .
b ?:> l - 8 3-1 l - C "-1'-C::S 3= School Official
Telephone # tilJ
Title
c: Applicant, Building Princi pal, Building Head Custodian, Security, Business Office (wit h certificate of insurance).
Name of
8-.tlC".J<.U PO! 0T C
Descriptibn of Activity

- , Lr- LL .r P 1_...1-, ()
I () m t=.,- re L. ! LLEt- , r_, 1n SU i 1//t?S1Tl/
Designated Contact from Sponsoring Organization: /1nm ':JDtll; n0. [ ) c>o!Y.)_ Ci:>i ! f py- , l'l1D,
, / J ' I
Address of SJ;onsoring Organization i a, lt-t.t6'rl6"'Z. D.:: I) e ( Q \r':\ ' N lf l t 11 ('
Phone: ?{ '.Ii l -0 L\ F) r::f- E-mail:a_.e:
1
J?.J.--1 "fi t2

U5 .
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
o Middle School
(6-8)
J( High School
(9-12)
Room Requested:
'b. Classroom
;x Gymnasium
___ Auditorium
___ Cafeteria
___ Field _____________ _
X Parking Lot ___________ _
Other (specify)
-----------
Date c)j Date Hours End: i1
Approximate Number of Individuals in Attendance: _____ (Attach roster if available.
No requests will be appro11ed with ow a jf' i11s1:ra11ce, even if one is already 011.file fl'itlz the district.'
AED Trained Individual .J)J ) c{ f1f'( (Please read back of form)
I . /"{ / _. - _-. , I
-. I / . I I I I (- -!--r
Purpose (Be Specific): I/; 1: ..-;.-:-- & LI C.C/t ,yv ..1.J- r r - .. 7 vu rs//
I
By my signature, below, I certify that I am authorized to act on behalf of the individual(s) and/or 1 6 2009
read, and understand the RPUFSD Board of Education policy #3280, Community Use of School Facilities-as wen-as--- -
organiz f ation, to be bound by the terms and conditions contained _ _ _ _ _ _____________ = _-_-_-__ -_-_-_-_ _ _ _ _ _ . -
-. /- / """- (} ,..., . : strict Use Only#
,>4(/w,.a_ ;-j../.Y..._,)( : Approved Date 7 I Of
, : /
/CJ__ lA'/.:? A-J...,/'A /"yJJ..._. /'---P_ D
Applicant's Address
lS3i ) J Official
,
Telephone # "'-.../

Title
05/01/2012 11:16 631-744-1394 PETER WAGENHAUSER PAGE 02/03
Jl.OC?KY SCHOOL :l>IllTll.Il?T
A:P:PLillA. TIOlf :l!Oil 'VSE OE 81lROOL :E'
Read RPUFSD 8001:d of.d11m.fion Policy 3280- C1J11tr111a1ity f./.wi o.f SchMI Far.iliri<-:s - /Jefmv Completing
Deslgnated Contact from Sponsoring Organization: .e __

Addr<1sofSponsoringOrganlzaUon -f?P . \;:: j I
Phone; . '1Ylf-I DzOQ x 16tD E-mail: \,=a.a I 'jcu .

q Joseph A Edgar Auditorium IJ
. CU-eteria . D 'f Y11 . t:.J-_ I 0 '6 /3'-f
.ct Field f
(6-8) Parking Lot nee( == ..
High School __ Kitchen (Requires Additionat Fees) 1V\
(9-12) . . _ .. C'-' Other (specify) .. OflC.".'l'>
Date . Date Encll\i!Ji' . Siarl: k A.Mlf!M
Approximate Number of Individuals in Attenda:u.ce: (Attach roster if available.
If roster is not available explain: .
Insurance Certificate Attached: c::J (Check l:tnx to lndlcAtt Approprl*ll! cerffficnte ofinsttrRlll!e la-attached to 11ppllention.)
No requests will he appro1cd lflitlinut a C<!rtljicate n.f tNtn if 011.t! a/J'earl}' 011.fi/q wj/ft tlte district!
AED Trained Individual p Q . ....,.... read back of form) .
Purpose (Be Specllc): C fu.__
.. c:.
-- : d
Fee Enclosed:$ (see BOE policy #3280 to cnlcnlate fee due for this event.)
(Make checks paya.ple to Rocky Point Schools)
Ry my signature, below, I certify that [ o.m autborizecftQ act on behalf of the lndMdual(s) and/or organi7.atlon(s)
listed as the sponsoring for the Indicated ievent(s). Furthermore, I certify that I have received copy,
read, aud understand the RPUFSD Board of Edncatio-. policy #3280, Community Use of School Facilities as well as
the terms snd conditions listed on the ,reverse hereof, iind sgree, on behalf of myself and the sponsoring
ofl!81llzatk>o, to be bou"Jf y "l!?""' and condltloononbined therehl.
J rlnu;0 . i[a1 __ ___
Ap,iPlican.h Signature ,r/ II
/"/J V .44..A---i, Disapproved ate. _ _ _
) l.A.,Pli6ant's 4d'dtess
. (T_ t-2 f ,,. <JI 3 - /Q 11./L/,_/?{)(.J
Telephone # ' ..,, / I J')
/'- tJ "' Title
c:: Appllcn11t, Bulldtng PrincipAI, BuOdl11g BCMI CuRtl)diiln, Sccurlry, B"alneu OlT'ce (with certlf'iCAtl: of
Iloi!KY FOilfT Si!HOOL
A..:FFLil!ATIOlf FOE. 'USE OF Si!HOOL
Read RPl:FSD Board of Educarwn Policy 32SO - Crmummity ( isc of School Faciliries - Before Completing Thi ..' 1lpplicarion
Date of Application: 'f ../
-;jV! o.f L{ -' o(_ DI 0
Designated Contact from Sponsoring Organization: __ Ch=-.. "- 1 "----' )'---- -=------
Address of Sponsoring Organization _______________________ _
Phone: E-mail:
--------------------- ----.,-------....,--------
0 h Mt- {M W''1tn
School Requested:
o Frank l Carasiti
(K-2)
o Joseph A. Edgar
/('.3-5)
o/ Middle School
(6-8)
High School
(9-12)
Date Date End:
Room Requested:
Classroom
Gymnasium
___ Auditorium
___ Cafeteria

___ Field _____________ _
Parking Lot

Other (specify) ______ +-----
Hours Start:_f_ Al\1/PM End:_i-/_Al\1/PM
Approximate Number of Individuals in Attendance: if {J (Attach roster if available.
If roster is not available explain: _________ __________________ _
Insurance Certificate Attached: D (Check box to indicate appropriate certificate of insurance is attached to application .. )
l\lo requests will be apprcwed wi1101u a cert(fi)re f even if one is already ou .fi.le fl'ith the district.'
AED Trained Individual /J
1
' , (Please read back'] of form) ;J '
Purpose (Be Specific): {_1_@ flviw - [ JJ:) {!/<y,eif affe! /,{ ff I/
---r- /)LUu 1 ,
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event .. ) C/ 0,,;.; , , ,L_.. -
(Make checks payaple to Rocky Point Schools) '
to be bound by the terms and conditions contained therein.

Signature .; i
(_/2 f :/(....--j..-.e_.e .. / c.._Cf A... r t:- i D Disapprove te __ _
Applicant67A.ddress :
<Zd ( 1/J3
Telephone#
Title
FoINT S:nooI.. l:>IST:R.It:T
A.FFLil:ATION FOB. '"USE OF St:HOOI.. F At:II..ITIES
Rend RPUFSD Board of Education Prilic:1' 32!:>0 - Community { !sc of School Facilirics - lk(or<! Completing This Applicarion
Date of Appli.(/g /(
0
.Kl? ai-iLk-1
Address of Sponsoring
Phone: E-mail:
School Requested: Room Requested: r ( b ( ()S\1 . c
o Frank J. Carasiti , Classroom 1 (J1
(K-2) '\,/ Gymnasium l r t (\ CJ( :_
D Joseph A. Edgar Auditorium v V )
-\
. I / (3-5) Cafeteria ii\ . :"\"""" i/'\ c:i (
I
v.rfl . ' .. Middle Field ,,0 v v I \
(\ l{ _ ----- . Parking Lot
rf\ _ U f-2. .. High School - Kitchen Additional Fees)
1
C....
l-- "f...j. CM / (9-12) ().
2
/ \ Other (specify) .
-rui5 (3'- 1 5ov--:i }
1
/
- I I ub'bate I . ours Start:__L
) _AC:iC...'1 q --- 7 r
on in Attendance: .:L (Attach roster if available.
,.;;-r-1-r ,
l\'o requests will be appro1ied wfrl lf a certW ate of insurance, even if one i.s already 011.file fl'ith the district!
. 17 .

organizati , to be bound by the terms and conditions contained __________ ------- _____________ _
I
1
, istrict Use Only
Approved Date ___ _
Applicant's Add.res

Telephone#
0
Autho,Zrt school official
Title
:FOIIT l>ISTJ:lif!T
A.I>I>Lif!ATION FO::R. 'USE OF F
Read RJ'UFSD Board of Educ!llwn P(J/icy 32.110- Community Use o/ School Facilirics - Be(orr! Completing This Applicarion
C/ftZ3t:LEttD1 .1VC:;z
G
u/1 fh l/lfP--.S7 VJ
Designated Contact from Sponsoring Organization: _________________ _
Address of Sponsoring Organization ________________________ _
Phone: E-mail:
--------------------- --------------
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
o Middle School
(6-8)
High School
(9-12)
Room Requested:
___ Classroom
___ Gymnasium
___ Auditorium
___ Cafeteria
___ Field _____________ _
Parking Lot __________ _
Date Start{p-0( :;--- Date End: -d.S-- Hours End: ___ Al\1!PM

Approximate Number of Individuals in (Attach roster if available.
No requests will he appro11ed without a certificate of i11sura11ce, even if one is already 011.fi/e fl'ith the district!
-------------------------------
APFLIC!A.TIO:N FO:R. USE OF S(}HOOL FAILITIES
Read RPUFSD Board cf Education 3280 - Community Use of School Faciliti.cs - BfifDrr! Completing Applicari.on
Date of
Hacf '-Lr 02 0 I I
) C>
. I
Phone: E-mail:

School Requested: r . ,.. Room Requested:
o Fran:k J . Car2.sfo. Classroom
(K-2) ,,,;, " ./ Gymnasium
o Joseph A. Edgar Auditorium
I (3-5) Cafeteria
1'21' Middle School Field

( 6 -8) Parking Lot _________ _
High School Kitchen (Requires Additional Fees)
(9-12) Other (specify) ________ _
F'r-/. t/:3 ti; Vk-:J<'IS:. .t/,oc.F/J1
Date Start:-/uc.s 6'/7Batc End: Holl!s Start: __ AM/PM End: ___
VJed-6/f Wed c;z: 1_r:.- 9 .:vt:J/
Approximate Number of Indhiduals in Attendance: (Ar..ach roster if available.
7s-
If roster is not available explain: __________________________ _
Insurance Certificate Attached: D (Check box to indicate approprfat e certificate of insurance is attached to application.)

a cert?:
1
o; fPrrh the
r
/f 6 \
Fee Enclosed:$ ______ (see BOE policy #3280 to calculate fee due for this 'event.) . . l I
(Make checks payable to Rocky Point Schools) c ' "1
' {D
c: Applicant, Building Principal, Building Head Custetdian, Security, Business Office (with certificate of insurance).
6pJj '

f9 ,-(0
(
cot) '
:;cJuo r
f.
<t .

<

IlOCKY POINT I>IST:B.. I C: T
AFl?Li iJ ATIOX FO:& "USE OF SCHOOL FACI::LI TIE
\"ame of Organizat ion:
ROC.Kj QC218f C.HEERLLADING.
,3- (; -//
Descnptrnn of ActiYity .
"lo R!Jf\J A KlD\2\.. r-o r Cheer ,vnd.rcu .. \
Designated Contact from Sponsoring Organization: lcl:

(6-8)
:i High School
(9- 12)
5AI
Date Start: 1-f -J
Date End: 1-f- ;{
Room Requested:
Class::oom
,/ GyiDJ.1asiurn <:iJ I 0
___ _ -\ud.1toriu:n
___ Cafeteria
___ Field _____________ _
___ Kitchen (Requires Addirional Fees) ..
1
!specify)
Hours Start:_fl_ .@:\1 End: I C1r'30A:'.\I@
Approximate ::\"umber of Indhiduals in Attendance: 1 00 (Attach roster if a"ai!aple.
lf roster is not aniiiab!e explain: __ -==:-------- ------- --- - - ------
Insurance certificate Attached: D (Check be1 to indicare 2ppropri:ue Certiiic2te of ir.sura;1ce is attached tv appiica1i on. 1
AED Trained IndiYiduai t'o.. (Please read back of for!!l)
-+- C.01 {6
Purpose (Be Specific): F cJnd k Lheex-\eo..de.x-5
Fee Enclcsed:S (see BOE policy =3280 to calce!iate fee due for this e':enr.)
(:\fake checks payable to Rocky Point Schools)
my signature. beiow, I certify that I am amhorized ro act on behaif of the individual ls) and 'or organization(s)
listed as the sponsoring organization for,the indica1ed e-em(s). fu.rtherwore. I cerrify d1ar 1 ha\'e r ecei\'ed a copy,
re2d, and understand the RPCFSD Board of Education policy Community Cse of School Facilities as" eii as
the ti::rms and conditions !isted on rbe re;-erse hereof. and agree. on behalf of myseif and the sponsoring
organization, to be bou d by the rerms and conditions contained therein .
.- --------strrct-Cse- -- j-j-------
ApproYed
Title
c: Building Princip:::L Building Hfad Ci..:stodi2n. 5ecurit: Building ar.d Grounds with cerrifkate ofinsurancf.
Ji.OfJKY FOINT SfJHOOL l>ISTilifJT
A.FFLifJATION FOil "'USE OF SfJHOOL FAfJILITIES
Read RPUFSD Board of Education Policy 3280- Cotnmunily Use o{Sc/200! Faciliries - Befori: Completing This Applicarion
r0G
o=i - fl -If
C-t-t--i::.r==-RLE&D i t\JG -ieuoLJ-1 JOl )
r\J . Eu re eDTt
1
S V t \( &;:; LTl (
I .
Designated Contact from Sponsoring Organization: A!\f tJ Pr <SPA-LL/ N ft
Phone: E-mail:
-------------------- -------------
School Requested:
o Frc;1l!d. Carasiti
(K-2)
Joseph A. Edgar
(3-5)
o Middle School
(6-8)
High School
Room Requested:
___ Classroom
, / Gymnasium Oh-D
___ Auditorium
___ Cafeteria
___ Field _____ _______ _
' (9-12) 5-7 .
) - -5prn - 7Pf'i\ i-f -;J,7 -
I Date Start: i-f Date End: t..f -d, Z Hours Start:li_ M End: / ()
Approximate Number oflndividuals in Attendance: / 0 {) (Attach roster if available.
If roster is not available explain: __________________________ _
No requests will he approl'ed without a of insurance, even if one is already 011.file ipifft the district.'
AED Trained Individual Ceo ch Syi,L \ r-a < I (Please read back of form)
. f)pps i 0,\ GJ \e'.-"r .
Purpose (Be Specific): FOE:._ WorKS fu)Q'S -t\4 o 1Ji0.
I \ '--...) I
Telephone #
c: Applicant, Building Building Head Custodian, Security, Business Office (with certificate of insurance).
Address of Spon:5ing
Phone: <P3 J - 2.1-0 't;6 'Z.
School Requested: , .,
o Frc.u..kJ. Carasiti
(K.-2)
o Joseph A. Edgar
(3-5)
Middle School
(6-8)
High School
(9-12)
Date - d. 7 Date End: 7-1
Room Requested:
___ Classroom
/. Gymnasium
___ Auditorium
___ Cafeteria
___ Field _____________ _
Other (specify) L.' aMfLI
I
Hours End:.,_1..._ .. __
Approximate Number oflndividuals in Attendance: JOO (Attach roster if available.
If roster is not available explain: ___________________________ _
No requests will be appro11ed without a of insurance. even if one is already on file f!'ith the district!
AED Trained lndividuaJbfbJJ,ihi../Rtssfy;o (Please read back of form)
Purpose (Be 'f-b'Y CJ-JU\ C-Anp
ocgan;zatio ' to be bound by the """' and oonditiom oon tained th:.r-ey;, -- -- - --- - --- - --- - -- --- --a----
_.1 - /-) : ,):listrict Use Only rJ /I
: 0 Approved Date '-' J //
: D
Appficant's Address1
Telephone #
c: Applicant, Building Principal, Building Head Custodian, Security, Business Office (wit
IlO(}KY POINT S(}HOOL I>ISTilI(}T
A.J?J?LI()ATION FOil USE OF S(}HOOL FA(}ILITIES
Rend R?L'F'.S'D Board of Edumrwn Pr>lic.)' 3280 - Cotnrmmizv Use of School Facilirics - Before Comple/7. ng App!icarion
(_)-+ FF__ RcF: .PfD i tib
:z-s- JI
Description of Activity '
QP,,-- \ r
e-1\ d '---i l I pl\
' l
Designated Contact from Sponsoring Organization: A OQ,, SflfrI_j _ _) r0A -- LeriPI"
I . : J, -
- r-.._ n p / c..Ss1 c:.#c..
i -z,. ur -r-'\ u
Phone: 1- 0'-\ S :::/-- E-mail: PiDS
School Requested:
\ J Fn.rs'.-d. Carasiti
Room Requested:
___ Classroom
(K-2) ...,c_ Gymnasium
(3-5) Cafeteria
1B-- Middle School Field _ ___________ _
(6-8) Parking Lot _ _ ______ _
(9-12) Other (specify) _________ _
-::.)0L../ -
Date Start: Date End: .3 \ 51 Hours End:
Approximate Number oflndividuals in Attendance: G () (Attach roster if available.
---- .
If roster is not available explain:
0
.
Insurance Certificate Attached: D (Check box to indicate appropriate certificate of insurance is attacbe_dto application.) 0 'K{J
No requests will be approved wfrhout a of insurafl ce. ne.;1 if one is al.ready on fi.I!! with-ihe distr.
1
.i'cf.' 1 U
\
A.ED Trained Individual (Please read back of form) L 7( ;

\-. r ' , 'f...
1
\\ /l \ \ L \ _
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event.) \ \ l \ . .
\ J t ''\. . \
(Make checks payable to Rocky Point Schools) \ \ ,... ,. }.
\ J
By my signature, below, I certify that I am authorized to act on behalf of the and/or \C \ ... r
listed as the sponsoring organizatiou for the indicated event(s). Furthermore, I certify that I have received a copy, t . ..-
read, and understand the RPUFSD Board of Educatiou policy #3280, Community Use o\ School Facilities as well as ., t-''\ ,
the .and conditions listed on the reverse and ag:ee, on myself and sponsoring \ \ '
orgarat1on, to by the terms and conditions contamed __________ .!.. _______ \ /
( \,.,/ /
1
, 1 (} " : Use / / _ _ //
: er' Approved /
,,,,,,. i ,, r '- I I I r
/ Applicant's Signature . : _ /
/- jz_. vOe.s fcttE:sTER 1< .P_ D
Applicant's Address
<6 a\ -ci..f s-:r
Telephone #
c: Applicant, Building Principal, Building Head Custodian, Security, Business Offi (with certificate of insurance).
Ilo()KY PoI.1fT S()HOOL I>ISTJl.I()T
API>LIC:ATION FOJ&. USE OF SCHOOL FAl!ILITIES
Read RPL'FSD Board of Educarwn f \>/i(.;r 3280 - Co111m1mii) l Zic of School Facilirics - Before Compietu1g 7'hi.o ,',.ppiicario;;
Date of Application: ]
-)
Designated from Sponsoring
, /
Address of Organization
Phone: a::a 1-Qy s=r
\
School \\
o .Frank J.
(K-2) "\\'
D Joseph A. Edg31'
(3-5)
1fL. Middle School
(6-8)
Higi'-i School
(9-12)
Date Start: 9 -3)-( [ Date End: 'f-30-l(
Approximate Number of Individuals in , en dance., (Attach roster if available.
If roster is not available explain: /
Insurance Certificate Attached: [Z] (Check box to indicate certificate of insurance is attached to application.)
l\'o requests will be approi>ed tt a cert(ficate of insurance. eveiN{_ one is already on.file with the district.'
AED Trained Individua, r , m.. G- '\ If back of form)
I
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for thl vent.)
--,<------
(Make checks p to Rocky Point Schools)
By my signa e, below, I certify that I am authorized to act on behalf of the individual(s) an or organization(s)
listed as the sponsoring organization for the indicated event(s). Furthermore, I certify that I h :ve received a copy,
read, and understand the RPUFSD Board of Education policy #3280, Community Use of School acilities as well as
the terms and conditions listed on the reverse hereof, and agree, on behalf of myself and the spons ing
organiza n, to be bound by th: terms and conditions contained __ \ ___ -f-----
' i
1\ -nn i \ '
.. f :J. V1JL.:fCilesft .w1Jf GL- o ,
.. Applicant's Address ' \
( {) !-/s-1- \,
Telephone #
c: Applicant, Building Principal, Building Head Custodian, Security, Business Office
Ilof:KY PoIXT Sc:e::ooL :l>ISTl.lICT
APFLICATIO!f FOE.. USE OF SCHOOL FACILITIES
PJ'UFSD Board of Educarzon Poiir:_i 32!;0 - Commun.iry l 'sc of School Faciliries - Bcforr! Completing This '1.pp!icc;rion
!2c:cK '-I Po\ n-t- CB EEBLEAD l!J$
Descriptio:d of Activity

I I
Designated Contact from Sponsoring
h
Address of Sponsoring Organization __________________ ,...... ______ _
Phone: B-;::+, 1-D'i '51 E-mail: . .oTJDl""\ltne .. f10-
School Requested:
o Frank J. Carasiti
(K-2) l'
o Joseph A. Edgar
(3-5)
):{ Middle School ( e
(6-8)
High School ( '
1
\,\ / /
(9-12) \ jv /
Date Start: i D -JJ- [f Date End:/ O-,Jf-11
'"7 t
Room Requested: o_ <.
Classroom '''
\7 Gymnasium
___ Auditorium
___ Cafeteria
___ Field _____ ________ _
Parking Lot

Otber (specify) _________ _
Hours Start:S
Approximate Number oflndhiduals in (Atrach roster if available.
Insurance c erttficate Atta ch ed: D (Check box to indicate appropriate certificate of insurance is attached to application.)
.'Vo requests will be a.pprol'ed wirhom a of fnsurrmce, ewm if one is already on .fil!! with the disrrict.'
A.ED Trained .jr1m .M ,a :
0
(Please read back of form)
i:5 llie'r ._,J
Purpose(BeSpecific): f'or t.JADO!Vft--L
Fee Enclosed:$ (see BOE policy #3280 to calcu_late fee due for this event.)
r ead, and understand t he RPUFSD Board of Education policy #3280, Community Use of School Facilities as well as
the terms and conditions listed on the reverse hereof, and agree, on behalf of myself and the sponsoring A'
" be ;mn ct by th, _,,nn, aod 'uct;tinn' oontain oo th f Ct U Se Ollly- _ --;,;-- __ _ ___
f[J(Xl j ){J\Approved Date I /. /(
ftpp1icant's_2?"gna'ture . Jp :
/ )It )f?..'.tt/Je0 fu-- Z) c 1J? C . : D Disapproved
Applicanr's Address
T eiephone #
c: Applicant, Building Pr inci pai, Buildin g Head Custodian, Business Offic2 (w . ., certificate of insurance).
::R.OCKY POIIT SCHOOL I>ISTAICT
AI>:PLIATIO!f FOJl "USE OF
Name of () I
L--1 v c:..c_c_.. - i< -r e.e
Description
1fQ=./\/\.tCfr01 ! LI Cl-
l '
Designated Contact from Sponsoring Organization: _ __,_if-i1_,_' __ ........ _,,,dO'""' )i{J:::... . _,,,,
Address of Sponsoring Organiza tion.-'='j,_'lf_l( __ ft;_. _u_rfe_ ..
Phone: '? 3 3 t.f ( E-mail: f , flt
o Frai-ik J. Carasiti Classroom
(K-2) Gymnasium
4 -+oJ1
q ( (S'"
(3-5) Cafeteria
o Middle School Field

n{_, , (6-8) Parking Lot
-(' High School . Kitchen Ad _itional Fees) I /i-
(9- 12) y.._ Other (specify) . . CA.V\l\ Lr.lJ" L c I I
A I '7 ii ; 0-VVl.tY !\.eu..v V\.VL,lS
Date Date End:.$/2#-- Hours Start:_5i_ End:
Approximate Number of Individuals in Attendance: JD (Attach roster if available.
If roster is not explain: n {?( SC 'flied) 'j e /----
Insurance Certificate Attached: D (Check box to indicate appropriate certificate ofinsurance is attached to application. )
/Vo requ c!.\ts will be U[lfJTOi'ed with out a certijicute i.nsu ranee. ei e11 if 01u! is al ready on file wir/J the districf.'
Purpose (Be Specific): 5'-le_ if , 9V} 41 f;y Si &l \
.\\ n Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event.)
By my signature, below, I certif) that I am authorized to act on behalf of the individual(s) and/or organization(s)
fe_()X""" listed as the sponsoring organization for the indicated event(s). Furthermore, I certify that I have received a copy,
'1..1. ; J.._Ct.,,read, and understand the RPUFSD Board of Education policy #3280, Community Use of School Facilities as well as
Obe terms and conditions listed on the reverse hereof, and agree, on behalf of myself and the sponsoring
o.-gi1""'.".' 'p liA aod coodit:.:alnod -; D iStrfo"f us;,-0 n1y- --------------
et. ff:f!J1f'i.ffuzy &Approved Date Cf-tL{-f\
e Applicant's SignE/-rurel v fl I/) / )
? -vJ 'f\Elll OCJl l.o_l;l_ f-.. l 0 ! ate __ _
\t\- \. Applicant's Address
\ Y3 J Lf{ (/[ AuthRr\zed .School Official
Telephone# 'rf1 !) l'e' \
Title
SW Updated 8/112010

IlO()KY POINT t:HOOL ])ISTilil:T
AI>I>LIATIO!f FOE. "USE OF -(;HOOL FAILITIES
:\aine of Organization:
r' 0 1 CAD: r V
L__J , ,___ r-.....-._. l '-..!...:;,
Description of Acthity
c..
1 ; ,.._, ,.- .,..-, ,..__ L) , .- o '"' \ r .=i
:-=s Ct::. p,_ \- 1 v L J \\ i-r C F'\
- . .
0
- 13- 11
\ I., c_ I
"K. i.. a..Q. 1 (__ . l I_ n ! L
Designated Contact from Sponsoring Organization; 4n rd: 5+'\u.J \\ fir{_; Don \">.Ci,,, La\ i IMJ Ltnff. \ \
I
Address _of Sponsoring Organization. ____________
Phone: -() C)'f E-mail: li5DA:-LLI Id.. tll/. 1)
School Req-;:iested:
:J Frank J. Carasiii
(K-2)
o Joseph A. Edgar
(3-5)
Ji. Middle School
(6-8)
:::i High School
(9-12)
Date Start:9 8:-/ / Date End: fJ --d f-/ (
Room Requested:
Classroom
_-"x'"-- Gymnasium
Auditorium
Cafeteria
I I )
___ Field ____ ________ _ _
Other (specify). _________ _
Hours Start: _.<\.i.\v@nd: '6' Al\v@
Approximate Number of Individuals in Attendance: _____ (Attach roster if aYailable.
If roster is not aYailable explain: __________________________ _
Insurance Certificate . .\ttached: 0 (Check box to indicate appropriate certificate of insuranc.e is arrac.hed to application.)
.:\ ;'; ;, :"-:' t.. 1 ,._.,.- , i f:t ' !' -_: ( =.:!: (: .. f .7 :' ,:c!-- :{ -: . _' .: i :\ :.[ ' i ;:. !;; _/i!l? ll:h ! i:o:? ilh z:rh:r .
1
A.ED Trained Individual ,::)C'o.,\ \ \. (Please read back of form)
I Col \\ER '0
Purpose (Be Specific): c u rv\ r r), I :-:ex: l\)oi 0110Jo
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event. )
By my signature, below, l certify that I am authorized to act on behalf of the individual(s) and/or organization(s)
listed as the sponsoring organization for the indicated event(s). Furthermore, I certify that I have recehed a copy,
organiz!ation, to be boun by the terms and conditions contained ____ ______________ _ M ______ j_ ___ _
' ' istrict Use Only
. >:::' . , '"' . : . Approved / I!
Appl cant's Sigr(atur - I

D
Applicant's Address
Telephone ;.
c: Applic.ant, Buildi ng Building Head Custodian, Security, Building and Groun .Yith c.enificate of insurance.
IlOCKY FOINT (;HOOL I>ISTilICT
A.J.>:l?LICA.TION FO::R "USE OF SCHOOL FAfiILITIES
RJad RPL'FSD Board (J( Educarw11 Policy 3280 - Community L of School Facilincs - Befori: Complerwg This Appiican.on
0 C.Ku. .p O\.'i'\+ h _.,. " \ e..ol_\ nc

Description of ActiYity
\-\e_e..,r \ \. C3. 'ii= \.J \
Designated Contact from Sponsoring Organization:[! h\'\ C ':)rc.._\.\C n C:.-: l \)D\w, s. c,\ \,e ,,..... I Len-t.::.J?c:';)';,\51
Phone: 8 0- \ -O ':\.5: -------E--m-ail_:_::S- ___ -:S--_Y,_E_f]-_\:> __ '-'l_e"""o..J,__o_?"G_o_l\._)_L\ uE . IVE.T
School Requested:
o Frank J. Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
Ci( Middle School
(6-8)
High School
(9-1 2)
Date Start: \G-d.5-11 Date End: IQ -d5-j\
Room Requested:
___ Classroom
Gymnasium
___ Auditorium
Cafeteria
---
___ Field _____________ _
Hours Start:L-f; DO A.'J\t@) End:
Approximate Number of Individuals in Attendance: i 0 0 (Attach roster if available.
Insurance Certificate Attached: D (Check box to indicate appropriate certificate of insurance is attached to application. )
,Vo requests will be approPed 1virhmu a certificate of insurance, even if one is al.ready on file fl' ith the district.'
AED Trained IndividualGcA.CJ--1 Sf)Jl\\rt:hf Et::.6o.\lc0-;---(Please read back of form)
. ,

Purpose (Be Specific): r 011 n r--n 1 Se.K Xu< t)o__JJ Oi"v.1S
Fee Enclosed:$ (see BOE policy #3280 to calculate fee due for this event. )
listed as the sponsoring organization for the indicated e''ent(s). Furthermore, I certify that I have received a copy,
the terms and conditions listed on the reverse hereof, and agree, on behalf of my}cl'f and the sponsoring
or gani tion, to be bound by the terms and conditions contained therein. /
;--- --/Dfst:I-icf use oii1),--- -- --
; Approved Date /{)
Applicant's Address
A
Telephone #
c: Appli cant, Building Principal, Building Head Custodian, Secu ri ty, Business Office (with certificate of insurance).
::ROCKY POINT SCHOOL l>ISTilICT
A.I>FLICATION FO:R "USE OF SCHOOL FACILITIES
Read P...PL'FSD Board o( Educarwn P"licy 3280 - Communir_1 l
1
sc o(Schooi Faciliri.cs - Before Cornplenng Thi.' -4ppiicanon
LEAD :)JS
q -1j-/ I
L \-\ \) I f\YCi
,,--- \ '
t-uno -
Designated Contact from Sponsoring Organization:-4. bro\ \; r'o n, ( n\ \ i.Pr. L tO- 1 l OJ
/ I ' ' I I ......)
School Requested: . .
o Frank J : Carasiti
(K-2)
o Joseph A. Edgar
(3-5)
Middle School
(6-8)
High School
(9-12)
Date Start: i I - i 0-i ! Date End: l \ -\ D -i 1
Room Requested:
___ Classroom
Gymnasium
___ Auditorium
___ Cafeteria
___ Field _____________ _
Parking Lot _ __________ _
Hours Start: End: 2 A_'!\v@
Approximate Number of Individuals in Attendance: I [) D (Attach roster if available.
If roster is not available explain: _________ _ _ ___________ _____ _
No requests will be approPed without a cert(ficcrte of insurance, even if one is already on.file fPith the dis.trier.'
AED Trained IndividuaJScn_\\\ IY'iJ?n7iJ\r,._, (cl read back of form)
I J" ,..) J c
Purpose (Be Specific): t="t> ffi rn\ <j Pr Sr-or No:\-\ On l\s
Fee Enclosed:$ (see BOE policj' #3280 to calculate fee due for this event.)
the terms and conditions listed on the reverse hereof, and agree, on behalf of rny
7
self arid the sponsoring ,
organiza/tion, to be bound)ly the terms_ and conditions contained -- --.- -,--mm mm mt l m
/ ' , : strict Use Only ,
: fj Approved Date '/J '/
;&ppli'cant's Signature . [) :
'f;i, ])r-. f<'. i D /:?
Applicant's Address ,&/ /
//p; d''
-Dl--\51- *i1ool Official
Telephone #
Ti
c:: Applicant, Building Principal, Building Head Custodian, Security, Business Office (with certificate of insurance).
Nov 22 11 04 34p Island Xtreme 5 '16-51 3-031 5 p.1
:B..OCKY 8Hooi l>ItiT.JlIC:T
AJ!:PLICA.TIDI ... 'l18:E O:E 8t:BOOL :F A.I:I.ITIES
o.fOrganization: .
.J... SI cv; c .Xt-re G?-e 1-t'""i 1-
Date 'f AppJication:
I J f-CJJ.-( 1 !
Description of Activity . _ . _
1-, iz f--,.-wc:J-i h,. r
Designated Contact from Sponsoring Organization: C(J eJ , s.,. r.... -;-o.---r-LS
Address of Sponsoring Organiution--'-/ ..:;..O_w..;.._ ....... __ -'"'.;..,.y_..,.. ' '-' "'=-k-""'-__.1..J""-'-f-+, --'-I ;.....17-'-'-'):...;:;S
Phone: 6 ?:i I q) I - 41; 1 "-1 E-mail: , s i 6 ... , c!.. yf:Ce. rn ?- @ c-(6 "-<-"'1.
r. L-1-
School Requested: RoClm Requested:
a Frank J. Carasiti Classroom
(K-2} -- Gymnasium
A. Edgar Auditorium
(3-5} Cafeteria
a Middle School Field
-------------
( 6-8) Parking Lot __________ _
o High School Kitchen (Requires Additiot:tal Fees)
(9-12) Other (specify) _________ _
Date Start: HnnrsStart: '.l,'>
6
!,b
Approrlmate N1;mber of d j / J 8 (Attacll rester if available. .
If roster is EIOt S\'Silable explain: q (CV 2 c{\vJ;uevt ts
1
Insurance Certificate Attached: Ci:] {Check 001 to intlicsle eppropriate =tifo:::s.te is .attached w appiicalion.)
,\'11 ri:quesrs will bi! oppmved wirlrfll1! a a;rtificale of if1.rnrmrcl!, ePl!CI if one i5 t1ln!ar( rm ftle wirll fht! di.r:trict.'
- AED Trained Individual Anf"\c"- 5r.;p. // 1:1 6 (Please read back offonn)
j,(_ L ff 1
Purpose (Be Specific): 'Las: hcuc.l-- 17 c . c k
7
Fb ....... f- Cb.
Fee EncJosed:$ {see BOE policy #3280 to calcalate fee due for this e\>ent.)
By my signatare, below, J certify that I am authorize.cl to act oo behalf of the iedividual(s) aDdlor organization(s)
listed as the sp-onsoring organization for the indicated event(s). Fu rthennore, I certify tbs.l I l:rave received a copy,
read, and understand the RPUFSD Board of Education policy #32-80, Community Use of Scbool Facilities as well as
tbe terms and conditioms listed on the reverse and agree, on behalf of myself and the sponsoring
orgaaiz.ati:oa, to be OO!lod by and coa.ditioosjconrined _____
77
______ _
fYI ,
1
/-\:0i&\U(?{l(/ Date 1
1
h1h
Applicant's Signature ' 01:-7- 1,
L 0 I ( $1-. F ()_.rL ili / r 7 J 5 0 :;:;;::; : D Disapproved Da::<:::t
Applicant's Address it
G:SI ezdt-Lft,1'--(
Telephone#
e: Appliellat, .BaHdiag PriodpaL Bnilding Head Cn.;todisn, Securit)', Building and Grtiullds witb rtifieate of ir.sorancc.
R L 8-Dl NG
...
-ro R.U/J A sV + VAR5try
Designated Contact from Sponsoring Organization:.:ANttJFf '5f?AU..l tJ A t J...etJ el? Pft651GJlFr
Address of Sponsoring Organization tr li>e tJ ft!! 71 !('
Phone: E-mail: _,Dp li'r\.e.hef
School Requested:
o Frank J. Carasiti
Room Requested: /
J ClassroornS ..
(K-2) >{ Gymnasium
o Joseph A. Edgar
(3-5)
Middle School
___ Auditorium
)(' Cafeteria f!fk,.iJL. 1'f f2.oo\"<'\
___ Field ____________ _
(6-8) Parking Lot

Other (specify) _ _______ _ _
Date Start: Date Hours Start:_2___@rpM End: 5 AMI@
tff212) ""' Fr#:'t.
Approximate Number of Individuals in Attendance: __ (Attach roster if available.
If roster is not available explain: _______ _____ _____________ _
No requests will be approPed without a of insurance, even if one is already on.file fl'ith the district!
AED Trained Individuall1uJi f & ,!/1ci_ (Please read back of form)
Purpose (Be CJQSB CJTrnP
(Make checks payaple to Rocky Point Schools)
read, and understand the RPUFSD Board of Education policy #3280, Community se of School Facilities as well as
the terms and conditions listed on the reverse hereof, and agree, on behalf of m elf and the sponsoring
organization, to be bound by the terms and conditions contained therein. ____ -r-f

__ f\. _L :
/a TQ_ua;. 1(/ 0 Disapproved Date __ _
Applicant's Address 11778
bBJ -&'0.1-D>i5f- S, oorificial
Telephone# t{_ :::h
Title ....
EXHIBIT 8
FACILITIES USE FEES COLLECTED
RECEIPT FACILITY USAGE
DATE ORGANIZATION AMOUNT DATE
9/2008 Rocky Point Owners, Inc. $120.00 11/8/2008
9/2008 Rocky Point Touchdown Club $150.00 10/5/2008
10/2008 Rocky Point Lions Club $200.00 10/26/2008
10/2008 Boy Scouts of America $40.00 1/17/2009
1/2009 Rocky Point Booster Club $280.00 12/14/2008
5/2009 Ticket to Broadway $1 ,250.00 5/17/2009
12/2009 CYO $3, 162.50 2008/09 season
3/2010 North Shore Youth Council $400.00 JAE summer prog.
--
10/2011 Rocky Point Lions Club $240.00 10/30/2011
EXHIBIT 9
Rocky Point School District Campaign Expenses made Payable to LIVCCC
Source:
Financial Disclosure Reports
3/4/2009 Friends of Vincent Demarco Rocky Point Cheer Club
82 Rocky Pt.-Yaphank Road, Rocky Point, NY
1$ 100.00 IConsv
11778
1/18/2010 Friends of Jane Bonner Rocky Point Cheerleading Club Rocky Point, NY 11778 I 100.00 ICNTRB
12/30/2010 Independence Party Chairman's Club LIVCCC Rocky Point, NY 11778 100.00 Print
1/7/2011 Friends of Tom Muratore LIVCCC 9 Old Orchid Court, Rocky Point, NY 11778 500.00 Print
1/8/2011 Smithtown Conservatives for Victory LIVCCC 544 Rte 25A, Rocky Point, NY 11778 100.00 Charity
1/17/2011 Friends of Vincent Demarco Rocky Point Cheerleaders
82 Rocky Pt.-Yaphank Road, Rocky Point, NY
100.00 Consv
11778
12/20/2011 Friends of Jane Bonner LIVCCC 544 Rte 25A, Rocky Point, NY 11778 I 200.00 ICNTRB
12/23/2011 Friends of Tim Mazzei
Long Island Varsity Cheerleading .
h . Cl b 544 Rte 25A, Rocky Point, NY 11778
C ampron u
I 100.00 !Donation
1/12/2012 Friends of Dan Panico LIVCCC 544 Rte 25A, Rocky Point, NY 11778 100.00 Print
1/12/2012 Friends of Judy Pascale LIVCCC - 100.00 CNTRB
1/20/2012 Citizens Committee to Re-Elect Senator Ken Lavalle LIVCCC 544 Rte 25A, Rocky Point, NY 11778 100.00 Journal ad
2/11/2012 Friends of Dan Los Quadro LIVCCC 544 Rte 25A, Rocky Point, NY 11778 500.00 Consv
12/12/2012 Suffolk County Conservative Chairman's Club l.l .V.C.C. NY 500.00 CNTRB
12/19/2012 Friends of Judy Pascale LIVCCC 544 Rte 25A, Rocky Point, NY 11778 100.00 CNTRB
1/25/2013 Islip Town Conservative Executive Comm. LIVCCC PO Box 321, Rocky Point, NY 11778 100.00 CNTRB
1/31/2013
Suffolk County Republican Committee Campaign Acct
LIVCCC 333 Rte 25A, Rocky Point, NY 11778 I 100.00 I Print
(SCRC)
Page 1of1

Rocky Point Cheerleaders

Încărcat de

Informații document

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Rocky Point Cheerleaders

Încărcat de

Drepturi de autor:

Formate disponibile

ANALYSIS OF THE EXTRA-CLASSROOM ACTIVITIES FUND FOR THE

ROCKY POINT NEW YORK SCHOOL DISTRICT CHEERLEADERS

__ ,_,.,_,_ ... 1""A...t!"' .=..------>.,(==-"fLk-=='

S-ar putea să vă placă și