Lamar High School



Lamar High School

Cheerleaders

&

Rangerettes Drill Team

Present

Lamar

Cheer

&

Dance Clinic

Learn Cheers and Chants

Learn a dance taught by the L.H.S Rangerette Drill Team

Receive a FREE T-shirt for performance

Perform with L.H.S Varsity Cheerleaders & Drill Team

At the

Saturday, October 26th game

Lamar

VS.

Madison

6:00 PM/ Delmar Stadium

Cheer Dance Clinic

October 26, 2013 8:30am-12:15pm

$25 EarlyRegistration (until October 25)

$30 Registration after October 25th

Lamar High School Gymnasium

Applications maybe obtained online at lamarhs

Recruited by_____________________

Registration Form

Participant’s Name:______________________________ Age:______

Address:_________________________________________________

City: Zip Code:____________

Parent/Guardian’s Name:____________________________________

Address:_________________________________________________

City: Zip Code:____________

Home Phone: Cell Phone:___________

Emergency Contact Information:

Name: Relationship:_____

Address: ___ _____________________

Phone Number: Cell Phone:___________

T-Shirt Size (circle one)

T-shirts will be reserved for those who register by Oct.25th . All other shirts will be distributed on a first-come, first-served basis.

Child Size: SM MD LG

Adult Size: SM MD LG

Lamar High School

Cheer and Dance Clinic

Medical Release and Waiver of Liability

I hereby certify that I am the parent and/or legal guardian of ,

the applicant. I also certify that my daughter/son is physically fit for strenuous activity according our family physician. In the event my daughter/son is injured or becomes ill while participating at the clinic, I hereby grant my permission on our family’s behalf, in case of an emergency, for Lamar High School personal or its agents to provide or seek medical assistance as many deemed necessary under then-existing circumstances. Further, I understand fully that individuals who participate in clinic activities are doing so at their own risk. I acknowledge that the Lamar High School personal and its agents are not responsible for any injuries that may occur to individuals participating in any clinic activity, and accordingly will not file legal action against and Lamar High School personal or its agents of this clinic. Participation is on voluntary basis only.

Signature of Parents/Legal Guardian Date

Medical Insurance Coverage

Company Name:

Policy Holder Name:

Policy Number:

Person to Contact in Case of Emergency:

Telephone Number:

LAMAR HIGH SCHOOL

CHEER AND DANCE CLINIC

Tentative Schedule

8:30-9:00 a.m. Registration/Breakfast (will be provided)

9:00-9:30 a.m. Stretch/Warm-up

(Divide into groups)

9:30-10:30 a.m. Learn Cheer/Chant/Dance

In their respective groups

10:30-10:45 a.m. Snack Break (snacks will be provided)

10:45-11:45 a.m. Learn Cheer/Chant/Dance

In their respective groups

11:45-12:15 p.m. Performance for Parents

Showtime

INFORMATION ABOUT THE CLINIC:

▪ Payment in form of cash, money order, or cashier check (checks made out to Lamar High School) no personal checks and no refunds

▪ Mail payment (no cash) with registration form and medical release to

Lamar High School

Attn: Ann Southwell

3325 Westheimer Rd.

Houston, TX 77098

▪ Attire for Clinic should be:

T-Shirt

Shorts

Tennis Shoes

Performance at Football Game will be at

Delmar Stadium

▪ Attire for Football Game:

T-Shirt from the clinic

Navy shorts

Tennis shoes

For more information, please contact Ann Southwell or Tara Williams @ 713-522-5960

**All walk-in registration will be subject to remaining sizes in shirts**

-----------------------

As Parent/Guardian of the above child, I do herby authorize his/her participation in the Lamar Cheer Dance Clinic. I agree to releases Lamar High, HISD, its agents, and employees from responsibility for injuries incurred during the clinic and or/any travel to and from the clinic. I authorize employees of Lamar Cheer and Dance Clinic to arrange for medical attention, which they deem necessary, should injury occur.

Print Parent/Guardian Name Parent/Guardian Signature Date

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