Host Club Head Over Heels Gymnastics 607-273-5187 ithacahoh@aol.com www.headoverheelsgym.net Event Dates May 2-3, 2015 Event Site Charles O. Dickerson High School (Trumansburg Central School District) 100 Whig Street Trumansburg, NY 14886 2015 USAIGC New York State Championships Levels USAIGC Copper 1, Cooper 2, Bronze, Bronze Diamond, Silver, Gold, Platinum & Premier Equipment Equipment provided by Sports Equipment Specialist Entry/Scratch Deadline April 11, 2015 Entry Fee (checks payable to Head Over Heels Gymnastics) $75 per Gymnast AA $20 per Event $40 per Team of 4 or More Gymnasts (Cooper & Bronze) $40 per Team of 3 or More Gymnasts (Silver, Gold, Platinum and Premier) Music ***All Music Must Be On an IPod*** Awards Age divisions are based on the gymnast’s age on the day of the competition Age group determination based on USAIGC rules All gymnasts will receive an All Around medal Graduating Seniors Please send a list of all of your graduating seniors Hotel Fairfield Inn & Suites Marriott 359 Elmira Road Ithaca, NY 14805 607-277-1000 Code: USAIGC States Rate: $139/night *must book by 4/1/15 – rooms are limited - complimentary breakfast, indoor pool Admission $10 – Ages 13 and up $5 – Ages 5-12 FREE – Ages 0-4 Please send entries to: Head Over Heels Gymnastics PO Box 2346 Liverpool, NY 13089 2015 USAIGC New York State Gymnastics Championships *Please use this entry form – One Entry Form Per Level – Please fill out entire entry form Club Name:___________________________________________________________ Email Address:__________________________________________ Club Address:________________________________________________________ Phone Number:____________________________________________ Club USAIGC #:________________________________ Contact Name:__________________________________________________________________ Level :_____________________________________ Gymnasts Name DOB USAIGC # AA (Check if this is what the gymnast is competing) Event Specialist (put the name of the event(s) the gymnast is competing) Name of sanctioned competition gymnasts attained qualification score and the score that was achieved Name of 2nd sanctioned competition gymnast attended Name of 3rd sanctioned competition gymnasts attended