KANSAS Cheer/Dance Mascots – PRE-REGISTRATION

Name of Coaches attending*:
Home Address*:
Name of School*:
School Address*:
Home Phone*:
Cell Phone*:
E-Mail*:
Desired Camp and Date*:
Number of Students attending (male)*:
Number of Students attending (female)*:
A deposit of $50 per student is required to confirm registration. Please mail check to Kansas NCA/DA, 4216 Wimbledon Drive, Lawrence, KS., 66047. We will send packet prior to deposit upon request.
	*Required field