Cal Poly Cheer & Dance Clinic
Saturday, September 10th, 2022
9:00am-11:00am
Ages 5-18
Meet at Cal Poly Track near Mott Athletic Center, Bldg 42
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Participant Name (Last, First) *
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Participant Grade *
Parent/Guardian Name (Last, First)
Parent/Guardian Phone Number (xxx) xxx-xxxx *
Parent Email *
Emergency Contact & Phone Number (other than parent) *
What school, gym, or organization is the participant affiliated with? If none, please indicate INDEPENDENT. *
Do you plan to march down with the Mustang Stampede parade prior the football game? 
-Meet @ 11:30am in front of Mott Athletic Center
-March down @ 11:40am
-Parent pick up in front of Spanos Stadium @ 11:55am
*
Do you plan to attend the optional 1st/2nd Quarter break field performance at the football game?
-Meet @ 2:10pm near Southeast corner, between sections 105/106
-Parent pick up immediately following on-field performance
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How did you hear about this event? *
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I understand that a signed waiver by parent/guardian and payment is required for participation. Items will be collected on the day of clinic during registration. *
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