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Mt Laurel Cheerleading

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                                                     MLCA
                                    Storm * Thunder * Lightning
                ---------------------------------------------------------------------------------
                             2011 Summer Cheer Camp
Dates / Time:            August 16 (Tues) 8:30am – 3:00pm
                         August 17 (Wed) 8:45 – 3:00pm
                         August 18 (Thurs) 8:45am – 2:00pm
                  August 18th @ 2:30pm Family & Friends Expo Performance in Hartford Gym

     * CHEER outfit (shorts and tee-shirt) for Thursday’s Expo performance will be provided for all
                                             enrolled in camp.
Place:          Hartford Middle School (Gym)
                Hartford Rd. & Hainesport/Mt Laurel Rd
Cost:    $135.00 per cheerleader
         Attendance is Mandatory for Lightning & highly recommended for Storm and Thunder.
                                            BACK by Popular demand:
                                Enjoy camp with a friend!!!!!
                       *Camp is OPEN to girls 2nd thru 8th grade.
                Whether you know someone interested in MLCA or just LOVES to CHEER!!!!!!
                Invite them to join MLCA’s Summer Camp…..
                       **Cost is $135.00
                (Includes 3 days of instructional cheerleading with Storm and Thunder squads & MLCA Camp Expo
                shirt/shorts)
           Please contact Jessica Mell jessicamell@comcast.net with any questions
                        PLEASE E-MAIL YOUR DAUGHTERS SHIRT AND SHORT size to
                   Jessica Mell @ jessicamell@comcast.net NO LATER THAN 08/1/11
                                         Expo outfit sizing chart:
                -Youth small/ youth medium/youth large
                -Adult small/ adult medium/ adult large/ adult extra large
        Please note:
         Registration may be accepted via on-line registration @ http://www.sportssignup.com/MLCA-Online-Registration.start
         and refer to the Open 2011 Summer Camp Registration link. (Payment may completed on-line with visa/mc or
         check……PLEASE NO CASH)
OR
        By mailing completed registration form found by linking to http://www.mtlaurelcheer.com/index.php
        then click on the FORMS section and refer to Open 2011 Summer Camp Registration along with payment to:
                                                                    MLCA
                                                              Attn: Camp ‘11
                                                                 PO Box 1253
                                                            Mt Laurel, NJ 08054
                                             **** All checks may be made out to MLCA ****
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                                MLCA SUMMER CAMP
                         RELEASE FORM & CONTACT INFORMATION

Registrars Name: ___________________________________________
DOB: ___________________________ Grade Fall 2011: ___________________________
Parent(s)/Guardian Name: _____________________________________________
Address: ____________________________________________
Parent/Guardian Phone Number (daytime): ___________________________________________
If yes: email address: _____________________________________
Does your child participate in a gymnastic/cheer tumbling program: yes / no
Emergency Contact Info:
Name: ________________________________________ (relationship to registrar)

Address: _________________________________ Phone number: ____________________________
Please list:
Allergies: ______________________________________________________________________

Current Daily Medication: ________________________________________________________

Physician’s Name: _______________________________                    Phone: _________________

Hospital Preference: _____________________________

Insurance Carrier: __________________________

In case of emergency, I ____________________________ authorize MLCA staff to secure
                                   (Print your name)

Emergency treatment for my child, _____________________________ (print child’s name)


____________________________________                   ___________________________________________
Parent/Guardian Name                                       Signature                   Date

        Acknowledgment of Risk and Liability waiver, and admission of Tylenol/Advil
*MLCA Staff will have age appropriate Tylenol and/or Advil. No over the counter medication will be
distributed without verbal consent from a parent or emergency contact.
 **I understand there may be risk of injury participating in cheerleading and tumbling; therefore I agree
  to waiver any and all claims of liability, release and hold harmless MLCA in the event such injury may
                                            occur to my child (ren).

				
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