Cheerleading Prep Clinic Registration
Please print this form and mail to the address shown below. Registration is fulfilled on a first come/first serve basis.
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Cheerleading Prep Clinic Registration Please print this form and mail to the address shown below. Registration is fulfilled on a first come/first serve basis. |
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| Date
of clinic: |
Sunday, 2 March 2008 |
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| Participant's
Name: |
_________________________________ Sex: M ___ F ___ |
Home Address: Email Address: |
_____________________________________
_________________________________ |
| Home Phone: | ________________________ |
| Age: | ____ Date of Birth: __________ Year graduating: ____ |
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| Parent/Guardian Name(s): | _______________________________________
_______________________________________ |
| Insurance Company: | ________________________ Policy Number: _____________ |
| Emergency Contact: | ________________________ Emergency Phone: ______________ |
| High School Attended: | ________________________ |
| High School Address: | _______________________________________
_______________________________________ |
| Coach/advisor name: | ________________________ |
| College(s) of choice: | 1st
___________________________________ 2nd ___________________________________ 3rd ___________________________________ |
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Please check the session(s) you'd like to attend: [ ] Session 1: $55 |
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| Amount enclosed: | ____________ CHECKS ONLY -- please do not send cash |
Make checks payable to Univ. of Delaware and mail to: Andy Brown 159A |
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