Cheer Camp - Grades K through 4 - Individual Registration

Participant's First Name *

Participant's Last Name *

Teacher Name *

Student's Grade *

T-shirt Age Group *

Youth

Adult

Adult T-shirt Sizes *

Youth T-shirt Sizes *

S

M

L

XL

Health Concerns / Diet / Allergies *

Please allow my child to ride home with

Emergency Contact Number *

Mother's Phone *

Main Contact Email *

Address *

City *

Zip *

Parents' First & Last Names *

Amount

$

Payment Method

Payment to be made through School Payment Portal

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

Individual Registration