7 Fun-Packed Camps Tumbling

2016
Are you ready to flip out?
7 Fun-Packed Camps
Tumbling: June 6 – 9
Team Gymnastics: June 13 – 16
Cheer: June 20 – 23
Recreational Gymnastics: June 27 – 30
Tumbling: July 11 – 14
Boys Gymnastics: July 18 – 21
Cheer: July 25 – 29
OPEN TO KIDS IN GRADES K-8
CAMP TIMES: 9am-12pm
Performance each Thursday @ 11:30am
Each Camper receives a T-Shirt (must register by 5/23)
Space is limited. Cost is $75. ($5 off each additional camp)
A portion of the proceeds
benefit the Pediatric
Therapy Fund at
1251 N. Fruitridge Avenue
Terre Haute, IN 47805
(812) 238-0002
illianagymnasticscomplex.com
2016
REGISTRATION FORM
Summer camps are open to all children currently enrolled in or entering grades K-8. You do not have to be a member of Illiana
Gymnastics to participate in camps. Camps are held at Illiana Gymnastics Complex, 1251 N. Fruitridge Ave., Terre Haute, IN. Camps start
promptly at 9 a.m. Drop-off campers no earlier than 8:50 a.m. Pick-up is at noon. Camps run Monday-Thursday, with a performance for
parents at 11:30 a.m. on Thursday of each week. You must register by May 23, 2016 to receive the camp T-Shirt. Mail your registration
with check payable to Illiana Gymnastics Complex: 1251 N. Fruitridge Ave., Terre Haute, IN 47805 or stop by to pay cash, debit or
credit card. Questions? Contact IGC Director Melissa Morris via phone at (812) 238-0002 or email: [email protected].
I am registering my child for:
Tumbling: June 6 – 9
Team Gymnastics: June 13 – 16
CAMPER’S NAME
(Some experience required for this camp.)
Cheer: June 20 – 23
Recreational Gymnastics: June 27 – 30
Tumbling: July 11 – 14
Boys Gymnastics: July 18 – 21
Cheer: July 25 – 29
MALE or FEMALE
SHIRT SIZE:
YS
BIRTHDATE
YM
YL
AGE
S
M
L
XL
2X
Does your child have a medical or non-medical condition that would
prevent him/her from participating in any activity? YES or NO
If yes, explain
PARENTS’ OR GUARDIANS’ NAMES
RELATIONSHIP TO CAMPER
ADDRESS/CITY/STATE/ZIP
PHONE NUMBER
NAME OF EMERGENCY CONTACT
EMAIL ADDRESS
CELL
RELATIONSHIP TO CAMPER
PHONE NUMBER
PERSONS WHO YOUR CHILD MAY BE RELEASED TO: THEY WILL BE REQUIRED TO PROVIDE A PHOTO ID AT PICK-UP
The cost of each camp is $75. If you are signing your child up for multiple camps, the first camp is $75 and each additional camp is
$70. I have enclosed a total payment amount for _____________________.
Illiana Gymnastics is a proud supporter of Union Hospital Foundation and will donate a portion of all summer camp proceeds to
the Pediatric Therapy Fund to help provide therapy for children who are in need, but are under-insured or face financial limitations.
WAIVER & RELEASE FROM LIABILITY
By this waiver, I, _______________________________________ assume any risk, and take full responsibility and waive any claims of
personal injury, death or damage to personal property associated with Illiana Gymnastics Complex’s activities and events organized by
IGC staff and owners.
I understand and confirm that by signing this WAIVER AND RELEASE I have given up considerable future legal rights. I have signed this
Agreement freely, voluntarily, under no duress. My signature is proof of my intention to execute a complete and unconditional WAIVER
AND RELEASE of all liability to the full extent of the law. I am 18 years of age or older and mentally competent to enter into this waiver.
PARTICIPANT’S NAME
PARENT’S OR GUARDIAN’S SIGNATURE
DATE
PHOTOGRAPHY INFORMATION: During camps, we will have staff and volunteer photographers taking photos of activities. By registering your child, you
are indicating that you understand that your child’s photo may be used for our promotional materials and that you are accepting this condition.