2012 SPORTS CAMP REGISTRATION

Child's Name:      Date of Birth (MM/DD/YY):     

 

Age (as of June 1):

 

Street Address:      Apt #:      

 

City, State:      Zip:

 

Home Phone:      Email:

 

Mother's Name:      Mother's Business/Daytime Phone:  

 

Mother's Cell Phone:

 

Father's Name:      Father's Business/Daytime Phone:

 

Father's Cell:

 

Emergency Contact Name (other than parents):

 

Emergency Contact Phone:

 

Allergies* or Other Medical Conditions (*we are a peanut-free zone):

 

Other People Approved to Release Your Child to and their Relationship to the Child: 

(children will not be released to others unless listed by parent)

 

T-Shirt Size (must be registered by May 27 to receive a camp shirt):

YS (6-8)      YM (8-10)      YL (14-16)      AS      AM      AL      AXL

 

Each child participates in one sport for the entire week. Please indicate your child's preference:

 Cheerleading (ages 6-12)

 Basketball (ages 8-12 only)

Baseball (ages 6-12)

Tae Kwon Do (ages 6-12)

Soccer (ages 6-12)

 

Medical & Liability Release:

Our goal is to provide a fun-filled and accident-free week of camp; however, no activity is without the possibility of unforeseen hazards which could result in injury. As a parent or guardian, please instruct your child in the importance of conduct which will insure safety and an enjoyable time while participating in Overcomers Sports Camp.

By selecting "I Agree" below, you, as parent, guardian, or other responsible party, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss or injuries to the child for whom you sign.

I give my child listed above permission to participate in this activity, and give my permission to the leaders of this sports camp to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity.

I also give my permission for the use of any photo or likeness of my child to be used by the sponsoring organization for their use in promotional materials.

 

I Agree      I Disagree (your child will not be permitted to participate in sports camp)