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CONATACT INFORMATION CONTAT 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: Choose a State 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 GLCC event?: Yes No If you answered yes... What event and year?

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

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

WHICH GLCC EVENTS ARE YOU INTERESTED IN? (check all that apply)   Rock'N Rec I Romeo, MI October 23, 2010 Salt Water Challenge Pensacola, FL January 29, 2011 Raging Rock Championship Little Rock, AR March 5, 2011             Derby CuP SLAM Louisville, KY October 23, 2010 Battle at the Lake Championship Akron, OH January 29, 2011 Chicagoland Championship Chicago, IL March 6, 2011             ROCK THE MITTEN DANCE REGIONAL Traverse City, MI October 23, 2010 Whirlwind Challenge Kansas City, MO January 30, 2011 Rock The Beach National Championship Myrtle Beach, SC March 12, 2011             Very Scary Championship Sandusky, OH October 30, 2010 Up State SLAM Rochester, NY January 30, 2011 The Showdown - Great Lakes Grand Nationals Detroit, MI March 19-20, 2011             Ohio River Challenge Cincinnati, OH November 7, 2010 The Michigan Challenge Novi, MI February 5, 2011 Cherry Blossom Challenge Doswell, VA March 26, 2011             Wild Badger Challenge Green Bay, WI November 13, 2010 Speedway Slam Ft. Wayne February 12, 2011 Northern Cup Challenge London, Ontario Canada April 9, 2011             Santa's Challenge Birch Run, MI December 4, 2010 Rolling Prairie Challenge Des Moines, IA February 19, 2011 Rock'N Rec II Romeo, MI April 16, 2011             Reindeer Challenge St. Louis, MO December 5, 2010 Allegheny Championship Pittsburgh, PA February 19, 2011

HOW DID YOU FIND THIS SITE? (check all that apply)   GLCC 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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