Lamar High School - Houston Independent School District
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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