Вы находитесь на странице: 1из 5

Timeless Twirl-O-Jacks

Presents
SFASU Twirling Camp 2011
“Evolution of the Diva”
Monday July 25 – Wednesday July 27, 2011
Stephen F. Austin State University
Location: SFA Twirling camp is sponsored by and located on the Stephen F. Austin State University campus, located
in historic Nacogdoches, Texas.

Eligibility: Participation in the SFA Twirling Camp is offered to any girl entering Kindergarten through 12 th grade and
interested in a fun filled week of twirling.

Twirling Camps Offered: (COMMUTERS ONLY!)


 SFA Half Day Camp for K – 5th Grade: $65 per person for Early Registration by Friday, July 1, 2011. $90 per
person if received by registration deadline Wed. July 13, 2011.
(Fees include tuition, camp T-shirt, camp CD, snacks, crafts & props)
 SFA Day Camp for 6th – 12th Grade: $125 per person for Early Registration by Friday July 1, 2011. $175 per
person if received by registration deadline, Wed. July 13, 2011.
(Fees include tuition, camp t-shirt, camp CD & lunch)

Refunds:
 $25 fee on refunds if notified by Wednesday, July 13, 2011. NO REFUNDS AFTER July 13, 2011

Payments: Send payments for camp by personal check, school check or money order to Candice Curbow, 644 FM
2664, Nacogdoches, TX 75965. (DO NOT MAIL CASH). Make checks payable to Timeless Twirl-O-Jacks.

Registration: Will be held at the Shelton Gym in the HPE Complex (#42 on map) located on SFASU Campus
 K – 2nd Grade Half Day Camp Registration: 8:00 a.m. to 9:00 a.m., Monday July 25, 2011
 3rd – 5th Grade Half Day Camp Registration: 1:00 p.m. to 2:00 p.m., Monday July 25, 2011
 6th – 12th Grade Day Camp Registration: 8:30 a.m. to 10:00 a.m., Monday July 25, 2011

Food Service: A variety of lunch options provided for 6th – 12th grade campers at the Dr. Baker Patillo Student Center.
Snack will be provided by the Timeless Twirl-O-Jack Alumni for the K-5th grade campers.

Classes Offered:
Half Day Camps: K-2nd Grades 8:30 a.m. – 11:30 a.m. & 3rd – 5th Grades 1:30 p.m. – 4:30 p.m.; Fundamentals,
Dance Twirl, craft session (K-2), optional 2 baton or prop (3-5)
Day Camp: 6th – 12th Grade 8:00 a.m. – 5:00 p.m.; Fundamentals, Dance Twirl, Feature classes, Drum Major,
Leadership, Prop routines, Dance, 2-Baton and Samoan Knives.

Instruction: All classes will be taught by the Timeless Twirl-O-Jacks. Students will be assigned to classes according
to ability.

What to Bring: Batons (multiple baton classes will be offered), water jug, knee pads, shorts, twirling shoes

Camper Supervision: Every activity of camp life is supervised and attended by one or more of the following:
A. Timeless Twirl-O-Jack Alumni – a group of former Twirl-O-Jack’s
B. SFASU Twirl-O-Jacks - members of the 2011 – 2012 T-O-J line

Insurance: All campers must have a signed medical release form in our files (provided in this packet). Insurance will
cover accidents or illnesses which occur at camp. Minor needs are served by University Health Services. Parents
are called immediately if illness is critical.

Final Demonstration: 6:30 p.m. on Wednesday July 27, 2011 at the Shelton Gym in the HPE Complex (#42 on map)
Attire: Black shorts, camp t-shirt and twirling shoes

Enrollment is limited! Enroll today to reserve your spot for a fun filled week of twirling and memories. For
questions please send email to camp director, Candice Curbow at twirlojacks@hotmail.com.
Timeless Twirl-O-Jacks SFASU Twirling Camp 2011
Registration Form
(only 1 registrant per form)

First Name:_________________________ Last Name:______________________________

Address:___________________________________________________________________

City:________________________________ State:_____________ Zip:_________________

Home Phone:_______________________ Office Phone:_____________________________

School Last Attended: ________________________________________________________

Grade Next Year: ___________________ Date of Birth:_____________________________

Email: _____________________________________________________________________
(please provide email to receive further camp information)

T-shirt Sizes: (Please circle)


Youth Sizes: S M L Adult Sizes: S M L XL

Check the program for which you are applying:


o K – 2nd Grade Half Day Twirling Camp from 8:30 a.m. to 11:30 a.m.
o 3rd – 5th Grade Half Day Twirling Camp from 1:30 p.m. to 4:30 p.m.
o 6th – 12th Grade Day Twirling Camp from 8:00 a.m. to 5:00 p.m.

Amount Enclosed: $____________________

The SFA Twirling Camp does not tolerate cases of vandalism, fighting, substance abuse and
other violations of camp safety regulations. No refunds are given in cases of expulsion from
camp. I understand that the camp reserves the right to expel a student on these grounds.

__________Parent __________Guardian (Check One)

Signature of Parent/Guardian
STEPHEN F. AUSTIN STATE UNIVERSITY
WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT

1. In consideration for participating in__________SFA Twirling Camp_________________________________, scheduled to begin


on__7/25/2011_____ and conclude on__7/27/2011__, and/or other valuable consideration, I hereby RELEASE, WAIVE, DISCHARGE AND
CONVENANT NOT TO SUE Stephen F. Austin State University, the Board of Regents, the State of Texas, their officers, servants, agents, and
employees (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out
of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, WHETHER CAUSED
BY THE NEGLIGENCE OF THE RELEASEES, or otherwise, while participating in such activity, or while in, on or upon the premises where the
activity is being conducted or in transportation to and from said premises.
2. To the best of my knowledge, I can fully participate in this activity. I am fully aware of risks and hazards connected with the activity, including
but not limited to the risks as noted herein, and I hereby elect to voluntarily participate in said activity, and to enter the above-named premises and
engage in such activity knowing that the activity may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY
FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or any loss or
damage to property owned by me, as a result of being engaged in such an activity, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES
or otherwise.
3. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS THE RELEASEES from any loss, liability, damage or costs, including court
costs and attorney's fees, that may incur due to my participation in said activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or
otherwise.
4. It is my express intent that this Release and Hold Harmless Agreement shall bind the members of my family and spouse (if any), if I am alive,
and my heirs, assigns and personal representative, if I am not alive, shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT
NOT TO SUE the above named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed
in accordance with the laws of the State of Texas.
5. I UNDERSTAND THAT THE UNIVERSITY WILL NOT BE RESPONSIBLE FOR ANY MEDICAL COSTS ASSOCIATED WITH AN INJURY I
MAY SUSTAIN.
6. I further agree to become familiar with the rules and regulations of the University concerning student conduct and not to violate said rules of
any directive or instruction made by the person or persons in charge of said activity and that I will further assume the complete risk of any activity
done in violation of any rule or directive or instruction.
7. I also understand that I should and am urged by SFA to obtain adequate health and accident insurance to cover any personal injury to myself
which may be sustained during the activity or the transportation to and from said activity.
IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability and Hold Harmless
Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements or inducements, apart from the
foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Release for full,
adequate and complete consideration fully intending to be bound by same.
IN WITNESS WHEREOF, I have hereunto set my hand on this____________________day of___________________________, 20____.

_______________________________________________
Participant

________________________________________________________________
Parent (if Participant is under 18 years of age or a dependent on parent's insurance
and taxes for the period of the event)
STEPHEN F. AUSTIN
MEDICAL TREATMENT PERMISSION FORM

Student's Name_________________________________________________________________________________________________
I,____________________________________, hereby give my permission, consent and authorization for any medical treatment deemed necessary
by a hospital or physician while in attendance at the camp. I agree to assume responsibility for the costs of transportation, including any specialized
evacuation and of any medical care. I appoint the event coordinator and/or director my lawful agent with power to authorize and consent to the
administration of medical treatment during the aforementioned event.

Home Phone (_______)_____________________________________Alternate Phone_______________________________________________

Health Carrier:______________________________________________________Policy No.:__________________________________________

Other Emergency Contacts:______________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

Please list all allergies, restrictions or health exceptions:________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

This form should be properly signed and turned in at the time of registration. In case of such accident or illness, I give permission for medical
treatment to be given to me as deemed appropriate. I will assume responsibility for any medical treatment as deemed appropriate. I will assume
responsibility for any medical bills incurred on my behalf and understand the university will not be responsible for any medical costs.

_______________________________________________
Student Signature

_______________________________________________________________
Parent (if Participant is under 18 years of age or a dependent on parent's insurance and
taxes for the period of the event)

ATTACH A COPY OF INSURANCE CARD YOUR CHILD IS COVERED UNDER


Timeless Twirl-O-Jacks
Parent/Guardian Information Sheet

Parent/Guardian Information:
Father’s Information:

First Name: _____________________________MI: ____Last Name:______________________

Address:______________________________________________________________________

City: __________________________________________ State:_________ Zip:_____________

Phone: Day: _____________________________ Cell:__________________________________

Email: ________________________________________________________________________

Mother’s Information:
First Name: _____________________________MI: ____Last Name:______________________

Address:______________________________________________________________________

City: __________________________________________ State:_________ Zip:_____________

Phone: Day: _____________________________ Cell:__________________________________

Email: ________________________________________________________________________

Other Contact Information in case of emergency:


First Name: _____________________________MI: ____Last Name:______________________

Address:______________________________________________________________________

City: __________________________________________ State:_________ Zip:_____________

Phone: Day: _____________________________ Cell:__________________________________

Email: ________________________________________________________________________

Вам также может понравиться