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CONTACT INFORMATION CONTACT Name: * Birth date: * Cell Phone: * Gym/Studio/School Phone: * Home Phone: * Email: *   Your status within the program: School/Gym/Studio Owner Coach All Star Director Parent Registration Administrator Other Booster President     Other:

PROGRAM INFORMATION Organization Name: * Physical Address: * City: * State: Zip: Outside US / Canada Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   * Gym/Team Website: Team Colors:   # of Cheer Teams in Program # of Cheer Athletes in Program # of Dance Teams in Program # of Dance Athletes in Program     Type of Program: (choose all that apply) All Star Cheer All Star Dance School Cheer School Dance College Cheer College Dance Rec/Youth League Cheer Rec/Youth League Dance Dance Studio   Have you ever attended a Game Day event?: Yes No If you answered yes... What event and year?

I WOULD LIKE MORE INFORMATION ON... (check all that apply)   Cheerleading Events Individual Skills Camps JAM U Dance Events Choreography Multiple Event Discounts National Competitions JAMfest The JAM Rewards Game Day Events The U.S. Finals JAMwear Merchandise Private Camps JAMcamps

WHICH OF THE FOLLOWING REPRESENTS YOUR TEAM/PROGRAM? (check all that apply)   Cheer Dance Both

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WHICH Game Day EVENTS ARE YOU INTERESTED IN? (check all that apply)           GAME DAY - cincinnati Mariemont High School Cincinnati, OH November 6, 2011 Game Day - chattanooga Hixson Middle School Chattanooga, TN November 19, 2011 GAME DAY - Lexington Lafayette High School Lexington, KY November 12, 2011 Game Day - louisville Eastern High School Lexington, KY January 28, 2012

HOW DID YOU FIND THIS SITE? (check all that apply)   Game Day Brochure Inside Cheerleader Magazine Word-of-Mouth American Cheerleader Magazine Dance Spirit Magazine Search Engine Cheer Biz Magazine The Cheerleader Magazine News Media

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