Camp Registration

Camper Name:_______________________ Address:____________________________ ___________________________________ Home Phone:________________________ Camper Age: __________ Grade:________ Camper School: ______________________ Allergies, Medications or Medical Problems: ___________________________________ Primary Physician:____________________ Phone Number:______________________

Wallkill Valley Cheer Camp

2012
Price includes: Camp T-shirt and instruction from camp clinicians What to Bring: Cheer sneakers, hair tie, snack, water bottle and a WINNING ATTITUDE!

Wallkill Valley Cheer Camp

In the case of rain/ thunderstorms the camp will be held inside the cafeteria

T-Shirt Size:
Youth: Medium Large Adult: Small Medium Large X-large

Parent/Guardian Information:
Name: ______________________________ Phone:______________________________ Emergency Contact:___________________ Phone:______________________________

June 26th June 28th

Available to participants ages 6-15

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Camp Information

Camp Staff
Camp Director Janet Tussey

PLEASE DETACH AND MAIL TO THE ADDRESS LISTED BELOW

(FILL OUT BOTH SIDES)

Dates: June 26 -June 28 (Tuesday-Thursday) Fees: $50.00 Individual/$80 Family (Mail-In by June 15 th ) Late Registration (Day of Camp): $60.00 Individual/$90.00 (Family) Make checks payable to: W.V. Cheerleading (Send payment in full or pay upon arrival at 4:15pm on June 26th)

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WAIVER : My child has permission to

attend the Wallkill Valley Cheer Camp. In the event of an illness or injury, I give permission to the Wallkill Valley Cheer Camp Staff to secure appropriate emergency medical treatment, and shall be responsible for any charges incurred for such treatment. I acknowledge that my child will be participating in a contact sport and specifically release the Wallkill Valley Cheer Camp and all its staff personnel from any claim resulting from injuries/medical conditions that she may sustain from camp. Parent/Guardian Signature:

Currently entering her 19th year as the Head Coach of the Wallkill Valley High School Cheer Team

In 2001 and 2005 she had National Champion Teams Asst. Director MaryRose Silvestri

Currently entering her 5th year as the Assistant Coach of the Wallkill Valley High School Cheer Team

** Correct T-shirt sizes can only be guaranteed if registration is received by June 15th**
Location: Wallkill Valley High School Gym
(Call school for directions- 973-827-4100)

Also Current and Former Wallkill Valley High School Cheerleaders

Date:______________________

Times: 5:00pm-8:00pm (Registration begins at 4:15 on the 26th) The Purpose of this camp is to teach proper form and technique in a safe and stress-free environment

CAMP ACTIVITIES:
Motion Technique Jump Class Sideline Class Cheer Class Dance Class

Mail to: Janet Tussey Wallkill Valley High School 10 Grumm Road Hamburg, NJ 07419 Questions ? 973-875-9880 DHemme1348@aol.c