Reuter Family YMCA Pop Warner Football and

Cheerleading Camp
Registration:
Registration is open now through June 4th

Session Date:

SPACE IS LIMITED!
Registration Fee: $95 member; $115 non-member
*Financial Assistance Available*

June 11th-15th

Camp Information:
Ages: Rising 2nd-5th Grade
Location: Reuter YMCA Gymnasium
Hours: 9:00 AM- Noon; Monday- Friday
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Reuter Family YMCA Youth Flag Football/ Cheer Camp Registration Form
Return this form with payment to Reuter Family YMCA Member Services

_____________________________________________________________________________________________________________________
Campers Name
Birth Date
Age & Grade
Sex
_____________________________________________________________________________________________________________________
Childs School
T-shirt Size (specify youth or adult sizes)
_____________________________________________________________________________________________________________________
Mailing Address
City
State
Zip
_____________________________________________________________________________________________________________________
Parent Contact
Phone
E-mail (Required)
_____________________________________________________________________________________________________________________
Emergency Contact (Name and Phone Number Required)
Please circle the session you choose:

Football

Cheerleading

I hereby, for myself, my heirs, executors, and administrators, waive and release any and all claims and damages I may have against the
YMCA of Western North Carolina and their respective agents, representatives, successor, and assigns, for any and all injuries which may
be suffered by me or my family. I agree to comply with YMCA policies and procedures and understand that my participation can be
terminated without refund for exhibiting inappropriate behavior or abuse toward the YMCA staff and/or facilities.

Signature

Todays Date

Please list any medical conditions or

Allergies