Oklahoma State University
2016 College Prep Clinic Registration Form
DANCE
Date of Clinic:
Sunday, February 28, 2016 (9:00 am – 1:00pm; registration starts at 8:15am)
Registration Deadline:
Registration Fee:
Wednesday, February 24, 2016
$45 a person for clinic and t-shirt ($10 late fee for Walk-ins)
**T-Shirts are not guaranteed for Walk-ins **
Name: ___________________________________________ Age: _______ Sex: M_____ F_____
Home Address:
______________________________________________________________________________
Email: __________________________________________________
Phone Number: _____________________________________
School Attending Now: _____________________________________
Year in School:________________________
T-Shirt Size: _____________
Emergency Contact: _____________________________ Phone Number: ________________________
**REQUIRED**
Insurance Company: _____________________________ Policy Number: _________________________
Insurance Policy Holder’s Name: __________________________________________
Make checks payable to Cowboy Spirit and mail to:
Cowboy Spirit
Oklahoma State University
Athletics Center
Stillwater, OK 74078
**DOWNLOAD AND COMPLETE A RELEASE WAIVER**
*** BRING YOUR INSURANCE CARD TO THE CLINIC***