Miramonte High School

Cheer & Dance Middle School Camp

REGISTRATION FORM

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Mail registration form and check made out to Miramonte High School to…Coach Cassandra Montgomery, 1052 Sunnybrook Road, Lafayette, CA 94549.

Camp Dates:  Feb 20,22, 2007 Practices from 3:45-5:30pm

                       Feb 24, 2007 Arrive @ 6 pm, Game starts @ 7pm

Camp Fee:          $80 (includes sweatshirt, pom pons, snacks)

Name of student______________________________________

Address_______________________________Phone_________

School_________________                                   Grade_________

Friends attending camp _________________________________

Circle preferred shirt size:  S            M       L  (women’s fitted style)

Parent Name_________________________ Email__________

Phone # where parent can be reached during camp___________

Parent/Guardian Permission:

I understand that my child named above will be attending the cheerleading/dance clinic at Miramonte High School on Feb 20,22 and 24, 2007.  I understand that there are risks involved in any dance or cheer activity and I will not hold Miramonte High School, any of Miramonte personnel, or Cassandra Montgomery, responsible in case of accident or injury at any time during the clinic or game activity.

 ____________________________Parent / Guardian Signature