Items denoted with a red asterisk * are required.
 * Cheerleader Name
 
First Name
M.
Last Name
 * Current Home Address
 
Address 1
Address 2
City
State
Zip Code
 * Parent/Guardian Name
 
First Name
M.
Last Name
 * Home Phone Number
 
 -  - 
(XXX)-XXX-XXXX
Cell Phone Number
 
 -  - 
(XXX)-XXX-XXXX
 * Parent E-mail Address
 
 * Emergency Contact Name
 
First Name
M.
Last Name

In case we are unable to reach you in an emergency situation, please leave the name and number of another contact person.
 * Emergency Contact Number
 
 -  - 
(XXX)-XXX-XXXX
 * T-shirt Size
 

The shirts are part of the $30.00 camp fee and will be given on the first day of camp.