Christ Lutheran Basketball Camp Registration 2018
Participant's Name (First and Last) *
Your answer
Grade Level in 2018-2019 *
Emergency Contact Person and Contact Number *
Your answer
T-Shirt Size *
Are There Any Physical, Mental, or Behavioral Issues We Need to Be Made Aware? *
Your answer
Parent's Name(s) *
Your answer
Parent's Phone Number *
Your answer
Parent's Secondary Phone Number
Your answer
Parent's Email Address *
For Reminders and Information
Your answer
Any Questions or Concerns for Mr. Weide?
Your answer
Parental Consent & Waiver of Responsibility *
I agree that on behalf of the enrolled participant named on this application form, Christ Lutheran and/or camp staff or employees will not be held responsible for any injury, accident, or loss of property, however caused. It is further agreed that all risks involved in participation in said camp are assumed by the student and his/her guardian, who are responsible for the medical fitness of the enrollee and for all medical costs incurred in case of injury while in attendance at Christ Lutheran Basketball Camp. By signing you are also giving your consent in advance for emergency medical treatment, should it be deemed necessary by the camp director(s).
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service