HCS Basketball Clinic Registration
Your Name
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Age
T-Shirt Size
Contact Phone Number
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Your Email Address
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Parent's Signature
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Insurance Information
If you have no insurance please type “No Insurance” below.
Insurance Company
Your answer
Policy Number
Your answer
I hereby certify that the above information is accurate and I give my permission for the use of photographs and videos of my child and myself to be used in Camp publicity and for my child to be transported to and from off-camp activities; for the release of medical records in case of illness or inury; and for this camper to engage in all camp activities, except as noted by me and/or an attending physician. If no insurance is available the Harlan Christian School is not liable for any and all accidents that may occur during our sponsored activity. (type your name in the place of signature)
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