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South Sound Cross Country Camp Registration
July 22-26, 2019
Lakes High School
10320 Farwest Drive SW
Lakewood, WA 98498
Email address *
Registration is due at the start of camp. You may mail payment in directly, or pay with cash, check, or card at the start of camp. Registration is $115 if this form is submitted by July 15. Late registration after July 15 is $130. *
Name *
Your answer
Age *
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Parent Email *
Your answer
T Shirt Size *
School *
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Grade for the fall of 2019 *
Street *
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City *
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Zip Code *
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Parent Phone *
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Parent/Guardian Name *
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Emergency Contact (Name and Phone)
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I hereby grant permission for my child to attend the South Sound Cross Country Camp and verify that my child has received a physical examination in the past year and is physically capable to participate in activities, some of which are physically vigorous, related to the camp. I understand that participation in a running camp, despite all reasonable precautions implemented for my child’s safety, carries a risk of injury. Consequently, I hereby, for myself, my child, heirs, executives and administrators, do waive and release any and all rights against all persons given responsibility by the South Sound Cross Country Camp and Clover Park School District for the conduct of activities and rendering of services to my child in association with our participation. I hereby authorize the staff of the South Sound Cross Country Camp to act for me according to their best judgment in any emergency requiring medical attention and waive and release all involved from any and all liabilities for any injuries or illness incurred by my child during his/her involvement at this camp. I have no knowledge of any impairment that would limit or preclude my child’s involvement in any activities commonly associated with this type of instructional camp. I agree that costs for treatment of injuries or hospitalization for illness or injuries incurred during the camp will be the responsibility of the parent or guardian of the camp participant. I agree that any insurance carried by the parent or guardian may be used to defray such medical and hospital costs.
A copy of your responses will be emailed to the address you provided.
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