Skyjumpers Connecticut Winter Class Application

Mail to: Russ VerSteeg   3 Lathrop Lane, Norwich, CT 06360

Individualized instruction designed to provide an opportunity to pole vault in an atmosphere that emphasizes safety, fun, socialization, and participation.

Name _____________________________________

Address____________________________________
             _____________________________________
             ______________________________________

Male _____ Female _______ Age _______

e-mail _________________________________________

Best telephone number _________________________

School ______________________________

2010 USATF Membership Number ____________________________

Grade  2010-11 _________________________________

Best Vaulting Height (Competition) _____________________

Sundays (11:30 am -1:00 pm)  ________    

Sundays (1:00-2:30)  ________

Sundays (2:30-4:00)  ________

Thursdays (5:30-7:00)  ________ * One Wednesday: December 15

8 Classes: Cost $250. Please make separate checks: 1) $125 to Russ VerSteeg and 2) $125 to Thames Valley Gymnastics.

8 Sundays

December 12, 19, 26; January 2, , 9, 16, 23; February 6

 

8 Thursdays “ One Wednesday

December 9, Wednesday December 15, 23, 30, January 6, 13, 20, February 3

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