Taught By:

Clinic Date: Deadline: Location: Cost: Ages 4-11

University of Kentucky Cheerleaders Morehead State University Cheerleaders Western Kentucky University Cheerleaders and more! Saturday, April 28th Monday, April 23rd St. Edward School, Louisville, KY! $75/attendee (price includes meal and KCC Clinic T-Shirt) Check-In begins @ 9:30 AM Showcase/Introductions Stunts Lunch Tumbling Check-In begins @ 2:30 PM Showcase/Introductions Stunts Dinner Tumbling

Comments/Questions

10:00 AM 2:00 PM 10:00 10:30 10:30 12:00 12:00 12:30 12:30 2:00

*Additional T-shirts can be requested at $10/shirt. Please specify below and include extra payment. These are first come first serve if not pre-ordered.

Ages 12+

3:00 PM 7:00 PM 3:00 3:30 3:30 5:00 5:00 5:30 5:30 7:00

Disclaimer

Included in the clinic will be instruction from multiple successful College Cheerleaders and a KCC Clinic T-shirt. Time will be split equally into tumbling and stunting.

Full Name of Participant Shirt Size YM Parent Name Phone Mailing Address Email Address YL AS AM AL AXL A2XL

I hereby certify that I fully understand the following: 1. Cheerleading involves a variety of gymnastics, motions, partner stunts, rotations and heights; therefore, participation in cheerleading involves some amount of danger of personal injury. I totally assume the risks involved by participating in this cheerleading clinic. I further realize that improper conduct of cheerleading activity could result in catastrophic injury, paralysis or even death. 2. I hereby certify that I have read, am thoroughly familiar with, and will carefully abide by the American Association for Cheerleading Coaches and Advisors (AACCA) guidelines for safety in college cheerleading 3. I further agree to hold harmless the Kentucky Cheerleading Center and the University of Kentucky Athletics Association, officers, directors, staff and cheerleading officials for any injury which I may incur by being a participant in the cheerleading clinic. Medical Insurance Company and Policy Number:

STATEMENT: I have read carefully this memorandum, and I understand and accept the information and requirements contained in it. Signature Date

School Age Highest Tumbling Skill Years of Tumbling Experience Highest Stunting Skill Years of Stunting Experience Grade Date of Birth

If under the age of eighteen years old a parent or guardians signature is required.

Signature

Date

Please send form & payment to:

Kentucky Cheerleading Center Attn: Josh Keeling 10513 Firview Court, Louisville, KY 40299

For more information:

Contact josh@kycheercenter.com or (270) 970-0841