Quantum Athletics Cheerleading, Tumbling, Ninja

2021 QUANTUM SUMMER CAMP REGISTRATION

Fee: $23/full day | $15/half day (4 hours or less) | $50 deposit
Campers Name*
First Last
Age*
Date Of Birth*
MM
DD
YYYY
Grade Completed*
Gender*
Parent / Guardian Information
Parent/Guardian Name*
First Last
Work Phone*
Cell Phone*
Email*
Address*
Street Address City ZIP / Postal Code
Parent/Guardian Name
First Last
Work Phone
Cell Phone
Address
Street Address City ZIP / Postal Code
Emergency Contact Information
Emergency Contact #1*
First Last
Phone*
Address*
Street Address City ZIP / Postal Code
Emergency Contact #2*
First Last
Phone*
Address*
Street Address City ZIP / Postal Code
Pickup Authorization
Who may pickup your child besides parent/guardian(s) listed above?*
(please include emergency contacts, if applicable)
Health Record
List all allergies, any special precautions and treatment indicated for these allergies (i.e., food, medication or environmental allergies).*
(please be sure to include ALL food allergies. type N/A if this question is not applicable)
List all medications or modified diets currently being administered to your child. If Quantum staff will need to administer medication, please place information below.*
(type N/A if this question is not applicable)
List any chronic physical problems and any history of hospitalization.*
(type N/A if this question is not applicable)
List any diseases that your child has had.*
(type N/A if this question is not applicable)
List your child’s current interests:*
(e.g., sports, bugs, frogs, dancing, reading, singing, etc.)
What days to you plan to attend each week?*
(days can vary each week, as long as your child attends on a regular basis)
- Select All
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Do you plan on attending Full or Half Days?*
(hours can vary each week, as long as your child attends on a regular basis)
- Full Days (7am-6pm)
- Half Days (less than 4 hours)
What size T-shirt does your child wear?*
- CXS
- AS
- CS
- AM
- CM
- AL
- CL
- AXL
Policy Agreement
1. I give permission for my child to participate in Summer Camp activities such as group led enrichment, swimming, movies, field trips, etc. both on and off location.

2. I give permission for my child to be included in pictures or other publicity connected with the camp, including Instagram, Facebook and other social media platforms.

3. I will purchase a pool pass to the Lockwood Pool for my child or send the daily admission fee. Daily admission fees will be charged to statement if money is not sent for daily admission.

4. I understand that if my tuition is not up to date, my child will be unable to continue attending until the balance is caught up.

5. We will run on a three strike policy this summer: The third time a problem behavior has to be reported to a parent, they will be no longer able to attend
*
I HAVE READ AND UNDERSTAND THE POLICY AGREEMENT*
Credit/Debit Card Agreement
Quantum policy requires that all clients have a credit or debit card on file for payment purposes. Your Credit/Debit Card information will be secure and can only be charged under the terms you specify below.

By providing us with your Credit/Debit Card Information, you authorize Quantum to automatically charge your card on a weekly basis if another payment is not secured. Cards will be run each Friday for the following week.

If the Credit/Debit Card information on file changes for any reason, you must notify Quantum as soon as possible. We will maintain a clear record of all payments and charges. However, in the rare case that an overpayment occurs, your account will be credited on the upcoming invoice or if the balance is zero and you no longer bring your child to Quantum, your Credit/Debit Card will be reimbursed. An email receipt will be sent to you as soon as the payment goes through. In the event of a declined charge, you will be asked for a new Credit/Debit Card number and/or alternate payment before your child can return to Quantum.
*
I HAVE READ AND UNDERSTAND THE CREDIT/DEBIT CARD ON FILE AGREEMENT AND AUTHORIZE QUANTUM ATHLETICS TO CHARGE MY CREDIT/DEBIT CARD A $50 DEPOSIT AND OTHER FEES AS STATED ABOVE.*
Credit Card Number*
Expiration Date*
Security Code*
Cardholder Name*
First Last
Parent/Guardian Signature*
Date
MM
DD
YYYY
CAPTCHA

Walkover/Kickover Clinic Registration

Parent Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Child #2
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Child #3
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Payment Information
Total
$0.00
Credit Card*

Card Details

Cardholder Name

Cartwheel Clinic Registration

Parent Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Child #2
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Child #3
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Payment Information
Total
$0.00
Credit Card*

Card Details

Cardholder Name

Valentines Parents Night Out

Parent Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Child #1 Membership*
Child #2
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Child #2 Membership*
Child #3
Child Name*
First Last
Child Date of Birth*
MM
DD
YYYY
Child #3 Membership*
Payment Information
Total
$0.00
Credit Card*

Card Details

Cardholder Name

Cookies And Cocoa With Santa

Parent / Guardian Name*
First Last
Phone*
Email*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Number of Participants*
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Payment Information
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

Parents' Night Out 8/28

Parent / Guardian Name*
First Last
Phone*
Email*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Number of Participants*
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Membership*
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Membership*
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Membership*
Payment Information
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

Parents' Night Out 11/20

Parent / Guardian Name*
First Last
Phone*
Email*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Number of Participants*
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Membership*
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Membership*
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Membership*
Payment Information
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

Parents' Night Out 10/24

Parent / Guardian Name*
First Last
Phone*
Email*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Number of Participants*
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Membership*
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Membership*
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Membership*
Payment Information
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

Parents' Night Out - 12/18

Parent / Guardian Name*
First Last
Phone*
Email*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Number of Participants*
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Membership*
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Membership*
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Membership*
Payment Information
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

September Back Handspring Clinic

Parent / Guardian Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Payment Information
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

October Beginner Clinic Registration

Parent / Guardian Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Payment Information
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

December Backbend Clinic Registration

Parent / Guardian Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Payment Information
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

September Cartwheel Clinic

Parent / Guardian Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Payment Information
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

December Tucks and Beyond Clinic Registration

Parent / Guardian Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Payment Information
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

October Ninja Clinic Registration

Parent / Guardian Name*
First Last
Phone*
Email*
Number of Participants*
Child #1
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
Payment Information
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Coupon
Total
$0.00
Credit Card*

Card Details

Cardholder Name
CAPTCHA

Parents' Night Out

2020 All-Star Cheer Placements Registration

Parent / Guardian Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Number of Participants*
Child #1
Child #1 Name*
First Last
Child #1 DOB*
MM
DD
YYYY
Child #2
Child #2 Name*
First Last
Child #2 DOB*
MM
DD
YYYY
Child #3
Child #3 Name*
First Last
Child #3 DOB*
MM
DD
YYYY
CAPTCHA

Open Gym

Easter Daytime Playtime (4/9)

Cheer Clinic

2020 Summer Camp Credit/Debit Card Agreement

Quantum policy requires that all clients have a credit or debit card on file for payment purposes. Your Credit/Debit Card information will be secure and can only be charged under the terms you specify below.

By providing us with your Credit/Debit Card information, you authorize Quantum to automatically charge your card on a weekly basis if other payment is not secured. Cards will be ran each Friday for the following week.

If the Credit/Debit Card information on file changes for any reason, you must notify Quantum as soon as possible. We will maintain a clear record of all payments and charges. However, in the rare case that an overpayment occurs, your account will be credited on the upcoming invoice or if the balance is zero and you no longer bring your child to Quantum, your Credit/Debit Card will be reimbursed. An email receipt will be sent to you as soon as payment goes through. In the event of a declined charge, you will be asked for a new Credit/Debit Card number and/or alternate payment before your child can return to Quantum.
*
I HAVE READ AND UNDERSTAND THE CREDIT/DEBIT CARD ON FILE AGREEMENT AND AUTHORIZE QUANTUM ATHLETICS TO CHARGE MY CREDIT/DEBIT CARD AS STATED ABOVE.*
Credit Card Number*
Exp Date*
Security Code*
Cardholder Name*
First Last
Child's Name*
First Last
Parent/Guardian Name*
First Last
Phone*
Email*
Signature
Date
MM
DD
YYYY
CAPTCHA

Parents' Night Out

Banana Split Party

St. Valentines Meet

Spring Cheer Session

Tiny Cheer

Ages: 3-5

Tuesdays – 5:30 pm

Youth Cheer

Ages: 6+

Wednesdays – 6:30 pm

.

Parent / Guardian Name*
First Last
Email*
Phone*
Number of Participants*
Athlete #1
Athlete #1 Name*
First Last
Athlete #1 Date Of Birth*
MM
DD
YYYY
Athlete #1 Gender*
- Male
- Female
Athlete #2
Athlete #2 Name*
First Last
Athlete #2 Date Of Birth*
MM
DD
YYYY
Athlete #2 Gender*
- Male
- Female
Athlete #3
Athlete #3 Name*
First Last
Athlete #3 Date Of Birth*
MM
DD
YYYY
Athlete #3 Gender*
- Male
- Female
Payment Information
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
CAPTCHA

Holiday Parents' Night Out - December 13th

Parents' Night Out

Parents' Night Out - November 2nd

Cookies & Cocoa with Santa

Quantum Athletics Cheerleading, Tumbling, Ninja

Confidence is Key.

Let's Build Confidence Together.

BIRTHDAY PARTIES

EVENTS

PROGRAMS

Flexible Class Options

View our full class schedule and find the class that is best for you.

View our full class schedule and
find the class that is best for you.