Angels Academy Camp Sign Up
Spring Break Camps: March 19-22
Basketball Camp- 9:00-Noon Ages 5-6, 7-8, 9-10, 11-12, 13-14
Dodgeball Camp- 12:30-3:30 Ages 6-10 and 11-16
Email address *
Child Name *
Your answer
Age *
Your answer
T-shirt Size *
Which Camp ex. Basketball, Dodgeball or Both *
Your answer
2nd Child Name
Your answer
Age
Your answer
T-shirt Size
Which Camp ex. Basketball, Dodgeball or Both
Your answer
3rd Child Name
Your answer
Age
Your answer
T-shirt Size
Which Camp ex. Basketball, Dodgeball or Both
Your answer
4th Child Name
Your answer
Age
Your answer
T-shirt Size
Which Camp ex. Basketball, Dodgeball or Both
Your answer
Parent/Guardian Names *
Your answer
Cell Phone # *
Your answer
Email Address *
Your answer
Home address-- City, State, Zip *
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Emergency Contact and Phone *
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Any Allergies or Inhalers- If yes, please explain *
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Additional Comments
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Release Statement
I, the undersigned, to induce the Wichita Angels (WA) and Angels Academy (AA) and any or all instructors conducting practices/activities, hereby give my consent and agree to release, indemnify, and hold harmless AA & WA from all damages for any claim arising out of any injury, physical or mental, to or loss of life by any participant, in any way related to any participants presence at or participation in AA & WA facilities or activities, including, without limitation any complications to such injuries caused/aggravated by any participants pre-injury state of health or refusal to obtain medical treatment based on any personal beliefs or otherwise. Furthermore, I hereby authorize personnel associated with AA & WA, as my agents, to take actions, to consent to medical/surgical exams/treatment as may be required in emergencies to preserve the physical well-being of any participant; provided prudent efforts have been made to contact any listed legal guardian to notify the same of the situation. I also consent to allow pictures or video of my child’s classes to be used in media promotions for Angels Academy and the Wichita Angels.
Signature Acceptance
I understand that typing my name below constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
Signature *
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A copy of your responses will be emailed to the address you provided.
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