2021 Beach Camp Registration
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Camper(s) Name - add all participants names separated by commas *
Camper(s) Date(s) of Birth - add all participants DOB separated by commas
Camper(s) school(s) - add all participants schools separated by commas
Camper(s) email(s) - add all participants emails separated by commas
Camper(s) USA Wrestling Card Number (if participant has one) add all participant card numbers separated by commas
Insurance Company, Name of Policy Holder, Policy Number *
Camper Social Media (Twitter, IG, Facebook, etc.)
Shirt Size
Parents Name *
Parents Cell Phone *
Parents Email *
Address, City, State, Zip
Waiver: I verify that my child has been seen by a licensed physician and is physically able to participate in this camp. I hereby authorize the staff of the Kerry McCoy Camp to act for me, according to their best judgment in any medical emergency, while there is an attempt to contact me. I waive and release this camp from any liability, injuries or illness incurred while attending this camp. The camper shall use the facilities of Cape Henlopen HS at his/her own risk. Kerry McCoy, LLC, Cape Henlopen HS or any member of the camp staff shall not be liable for any damages. *
Required
Please provide specific written instructions for any special medical conditions that you deem necessary while participating in this camp.
Parent/Guardian Digital Signature *
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