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2018 Basketball Camp Registration
This form should be used to register of the Kayhi Basketball Skills Camp.
Grade next school year.
Emergency Phone Number
Ketchikan Skills Camp (June 11 - 13) $60
Grades 2nd -5th (Boys and Girls) 9:00 a.m. – 11 a.m.
Grades 6th – 8th (Boys and Girls) 11:00 a.m. – 1:00 p.m.
How will you submit payment?
Mail to Coach Stockhausen • 136 W. Fireweed Ln., Ketchikan, AK 99901
Pay at the door
Consent for Medical Treatment (Minor)
I recognize that the activity for which I am registering my child involves a risk of injury. In consideration of your accepting this registration, I waive and release any and all rights and claims for damage I may have against camp instructors and / or KGBSD for any and all injuries received by my child while participating in this activity.I hereby give my consent to emergency medical treatment as may be needed for the welfare of my child. I give my permission to release the necessary medical information to whomever is in need of such information should an emergency situation occur. By checking the following box you agree to the above.
I agree to the Consent for Medical Treatment (Signature will be required at the door)
Signature _________________________________________________ Date ________________________________
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