Cy-Creek High School Cheer Clinic PLEASE MAKE CHECKS PAYABLE TO CCCBC! Saturday, October 7, 2017 9:00 am – 2:00 pm Registration form must be received by: Friday, September 25th in order to receive a free t-shirt and guarantee the size - $40 (From Sept. 26-Oct. 6 no guaranteed t-shirt with registration) OR Register at 9:00 am on October 7th (in the Cy-Creek cafeteria at Grant & Mills Roads - $45 AGAIN THIS YEAR: Ages 4 through Grade 8 $40 for the clinic (donut upon arrival, includes lunch: pizza, chips, fruit, dessert & water) Photo with a Cheerleader! Includes a special appearance at our Lighting of the CC’s on October 18th! Instruction from Cy Creek High School’s cheerleaders with certificate of completion. PARENT SHOW AT 2:00 pm Please mail to: Cy-Creek High School Attention: Allison Marz, Cheer Coach 9815 Grant Road, Houston, TX 77069 (Must be received by September 25th for a free t-shirt. From September 26th thru October 6th – no guaranteed t-shirt with registration!) Clinic & Registration questions email: Susan Vandenbossche: suevanden2@comcast.net or Andrea Harper: andreaharper07@hotmail.com T-shirt size: YS YM YL AS AM AL (PLEASE circle one if pre-registering) Pre-Registration by September 25th $40____________ Sept. 26th - Oct. 6th Registration $40 ____________ (no guaranteed t-shirt) October 7th Door Registration $45____________ Cash__________ Check #_______________ ($40/45 per participant non-refundable) The Spirit Store will be open for Cheer Purchases!! Hands on your Hips, a Smile on your Lips, Spirit in your Heart, We’re Ready To Start! PLEASE MAKE CHECKS PAYABLE TO CCCBC! CY-CREEK HIGH SCHOOL CHEERLEADER CLINIC-2017 Registration Form Participant Name:____________________________________________________________________________ School:__________________________________________________________ GRADE/AGE:____________ Home phone:______________________ Address:_________________________________________________ City, Zip code:_______________________________________________________________________________ Email Address:__________________________________________________________ Mother’s Name:________________________________________ Cell Phone:___________________ Father’s Name:_________________________________________ Cell Phone:___________________ Family Physician:________________________________________ Phone:_______________________ Emergency Contact Name and Phone: ____________________________________________________________ (*Parents will be called first) ATHLETIC AGREEMENT The undersigned parent or legally appointed guardian of _______________________________________________________ does hereby consent to said student’s participation in all events conducted during the Cy-Creek Cheerleading Clinic, October 7, 2017. The events require much physical activity; however, precautions such as warm-ups and faculty supervision will be provided. I further agree to hold Cy Creek, it’s Board of Trustees, administration, and/or faculty harmless from all liabilities for any injuries which the said student may receive while participating in this event. _______________________________________________ _____________ Signature of Parent or Guardian Date /SEV cheerclinicform3 8/12/17