Hurry and Register- Space is Limited
                     MAIL TO or CARRY TO:
          East Duplin HS Cheerleaders: Attn: Emily Sandlin/Katlyn Rogers, Cheer Coach
                    394 N NC Hwy 111, NC 28518
              PANTHER CHEER CAMP – PreK – 6th Grade
                     Registration Form
               Thursday, October 6, 2016 3:30-6:30pm
        Please fill out this form completely and mail it in with your cash or check in the amount
          of $40 no later than September 20, 2015 to guarantee a spot and a tshirt.   
               Please make checks payable to East Duplin High School.
               Checks will be deposited the day they are received.
                 PLEASE PRINT ALL INFORMATION:
         If you are registering more than one camper, please use separate registration forms.  
        Camper’s Last Name:__________________First Name:_______________MI:___
        Age:____ Grade:________ School:____________
        Address:__________________________________________________
        City:______________________ State:_________ Zip:_____________
        Parent/Guardian 
        Name(s):_____________________________________________________________
        Address:______________________________________________________________
        City:_____________________________ State:___________ Zip:________________
        Email:_______________________________
        Home Phone:____________________________ Cell Phone:____________________
        Sign In/Out Contact Information (Person signing the camper in & out – NEW THIS
        YEAR. If different person for both, please list on back.)
        Contact’s Name________________________________________________________
        Relationship _____________________   Cell Phone___________________________
        T-Shirt Size (Please circle your child’s size):
        Youth Sm (6-8)    Y Med (10-12)    Y Lg (14-16)      
        Adult Sm      Adult Med      Adult Lg
        How did you find out about the Panther Cheer Camp?________________________
        *Your cheerleader will receive a snack, water, and ribbon upon arrival. He/she will get in
        FREE to the Southwest Onslow football game Friday, October 7, 2016 with his/her shirt
             from camp. We will perform at halftime (approximately 8:30.)*
                  Hurry and Register- Space is Limited
                     MAIL TO or CARRY TO:
          East Duplin HS Cheerleaders: Attn: Emily Sandlin/Katlyn Rogers, Cheer Coach
                    394 N NC Hwy 111, NC 28518
                  NEW THIS YEAR AT CHEER CAMP
         PARENT DROP OFF/PICK UP:  The person picking your child up must match the
         name on the registration form. ID will be required. Your child’s safety is what is most
                       important to us. 
        INCREASED SECURITY: No child will be let out of the gym until cheer camp is over.
        They will be escorted out to use the bathroom if necessary. Parents will have to check in
                    to pick up/drop off their child. 
         TSHIRTS, SNACKS, BOWS: Each child will receive these on the day of cheer camp.
         Their t-shirt and bow should be worn on Friday night. This will be given to the parent
                       upon pick up.
        THEY WILL LEARN: A cheer, a dance, jumps, some “tumbling” and minor “stunting”
        DIGITAL FILE PICTURES: Pictures will be taken throughout camp. Pictures will be
         uploaded to the East Duplin Cheerleading Facebook page, and the files can be sent
                 electronically should you want to print them. 
                       Liability Waiver
        I understand that my child, (child’s name __________________________) will be 
        participating in the East Duplin High School Cheer Camp on October 6-7, 2016. Since 
        this is a voluntary program, I will not hold the school, staff members, or cheer team 
        members liable for any accidental injury, which may occur.  I also understand that should 
        my child will not be signed in or released until the listed contact is present to sign. In case
        of a medical emergency, I do give consent for my child to be treated at the nearest 
        emergency room. 
        Please list any allergies or health concerns we should be made aware of for your child, 
        and any required special medications or 
        treatments:____________________________________________________
        Is there anything else we should know about your child? (Custody issues, special 
        modifications, etc) 
        ________________________________________________________________________
        _____________________________________________
        Parent/Guardian Signature________________________________________
        Date____________________
                  Hurry and Register- Space is Limited
                     MAIL TO or CARRY TO:
          East Duplin HS Cheerleaders: Attn: Emily Sandlin/Katlyn Rogers, Cheer Coach
                    394 N NC Hwy 111, NC 28518