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Ready to Sign Up for Cheerleading? Kehler’s National Champs All Star Cheerleading

31/2 Ages to 18

Evaluations & Squad Placement Days 31/2 to 5 yrs. Friday May 14th 6 - 7:30PM $10* 5 to 8 yrs. Friday May 14th 6 - 7:30PM $10* 8 to 12 yrs. Saturday May 15th 4:30 - 6:30PM $15* 13 to 18 yrs. Sunday May 16th 4:30 - 6:30PM $15*

Register by 5/2/10 (Add $5 late fee after that date)

Training Day for Evaluations Sunday May 2nd (Ask for Flyer or see mykidsgym.com)

Current Kehler’s Tumble & Trampoline Permission Form signed by parent after 9/1/09 required.

Details available at mykidsgym.com ✰✰✰✰✰

Kehler’s Gymnastics Ctr. Inc. Cheer Squad Evaluation Registration Form 2010 Parents must sign a permission form at the gym before the student may participate. Please arrive 15 minutes early each day.

1

Print Clearly Please (One Cheerleader per Form Please)

Name:_____________________________Street______________________Town

____________________Zip____________

Phone day:(

)______________

evening:(

)______________

Girl

__

Age____

Date of birth:___/___/___

.

Total Paid: $

. Ck.#

cash rec#

email:

____________

_______

_____________

_______________________________

2

Check ONE: 31/2 to 5 yrs. Friday May 14th 6 - 7:30PM $10* 5 to 8 yrs. Friday May 14th 6 - 7:30PM $10* 8 to 12 yrs. Saturday May 15th 4:30 - 6:30PM $15*

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13 to 18 yrs. Sunday May 16th 4:30 - 6:30PM $15* Register by 5/2/10 (Add $5 late fee after that date)

3

I have signed a current permission form.

I have not yet signed a current permission form but will before Evaluations Day.

Current Parent Permission Form Signed after 9/1/09 must be on file. Also sign Back of this form.

4

Parents signature

_______________________

Date:

_________

Print Clearly Cardholder’s name:

Credit Card Information (Use form ONLY when mailing) ____________________________________________________________

VISA

MC

Discover Card number:

_______________________________________________

E x p . d a t e ( M o n t h / Y e a r ) : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Billing address must match above address. I h e r e b y a u t h o r i z e K G C I n c . t o c h a r g e m y c r e d i t c a r d c a r d f o r t h e a m o u n t c h e c k e d a b o v e . $ 1 0 m i n i m u m .

Cardholder’s signature:

________________________________

Date:

_____________

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