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CONTACT INFORMATION

CONTACT Name:

Birth date:

Cell Phone:

Gym/Studio/School Phone:

Home Phone:

Email:

Your status within the program:


	Gym/Studio Owner		Coach
	All Star Director		Parent
	Registration Administrator		Other
	Booster President

	Other:

PROGRAM INFORMATION

Organization Name:

Physical Address:

City:

State:		Zip:
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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 COA event?:

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If you answered yes... What event and year?

I WOULD LIKE MORE INFORMATION ON...

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Cheerleading Events	Choreography	Multiple Event Discounts
Dance Events	The U.S. Finals	The JAM Rewards
National Competitions	COA Camps	JAMwear
COA Events	JAM U
Private Camps	Individual Skills Camps

WHICH OF THE FOLLOWING REPRESENTS YOUR TEAM/PROGRAM?

(check all that apply)

Cheer

Dance

Both

WHICH COA EVENTS ARE YOU INTERESTED IN?

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	Holiday Kickoff Challenge Columbus, OH November 20, 2011
	Central Indiana Cup Indianapolis, IN December 4, 2011
	Cornhusker Challenge Omaha, NE December 4, 2011
	Wright State Cup Dayton, OH December 4, 2011
	Music City Challenge Nashville, TN December 10, 2011
	Steel City Cup Pittsburgh, PA December 17, 2011

	Desert Sun Challenge Phoenix, AZ January 28, 2012
	Midwest National Pure Championship Columbus, OH February 24-26, 2012
	River City Challenge Jacksonville, FL March 4, 2012
	Georgia Peach Challenge Augusta, GA March 18, 2012
	Mid America Championship Kansas City, MO March 31-April 1, 2012
	ULTIMATE National Pure Championship Orlando, FL April 5-8, 2012

WHO IS YOUR JAMCARE REP?

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HOW DID YOU FIND THIS SITE?

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COA Brochure	Inside Cheerleading Magazine	Word-of-Mouth
American Cheerleader Magazine	Dance Spirit Magazine	Search Engine
Cheer Biz News Magazine	The Cheerleader Magazine	News Media

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