CCA Summer Camp Registration 2025

CCA Summer Camp Registration 2025
PERSONAL INFORMATION
Camper Name*

First NameLast Name
Parent Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Phone Number*

Area CodePhone Number
E-mail*
Camper Age*
Please list any notes/allergies/or specific information about your child that we should be aware of:
Emergency Contact Name (Other than parent):

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
REGISTRATION INFORMATION

My Products - Reserve your spot by paying the deposit for each week you are attending*

Week One Deposit June 9th-13th$100.00

Remaining balance of $150 will be due the Monday of camp.

Week Two Deposit June 23rd-27th$100.00

Remaining balance of $150 will be due the Monday of camp.

Week Three Deposit July 7th-11th$100.00

Remaining balance of $150 will be due the Monday of camp.

Week Four Deposit July 21st-25th$100.00

Remaining balance of $150 will be due the Monday of camp.

Week Five Deposit Aug 4th-8th$100.00

Remaining balance of $150 will be due the Monday of camp.

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

WAIVER AND RELEASE

As legal guardian of the child listed above, I hereby consent for him/her to participate in tumlbing classes/practices held at Cheer Challenge All-Stars, Inc. I recognize that any activity involving height or motion can create the possibility of injury including permanent paralysis and even death from landing or falling on the head or neck. I hereby forever release the Cheer Challenge All-Stars, Inc. officers, directors, agents, and employees from all liability for any and all damange and injuries suffered or contracted as a result of participation in any activity at Cheer Challenge All-Stars, Inc.

I hereby verify that I fully understand and accept the above conditions for permitting my child to participate in activities at Cheer Challenge All-Stars, Inc.
Signature*

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