Christ Lutheran Basketball Camp Registration 2018
Participant's Name (First and Last)
Grade Level in 2018-2019
Emergency Contact Person and Contact Number
Are There Any Physical, Mental, or Behavioral Issues We Need to Be Made Aware?
Parent's Phone Number
Parent's Secondary Phone Number
Parent's Email Address
For Reminders and Information
Any Questions or Concerns for Mr. Weide?
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).
Yes, I have read the above and consent to the terms as stated.
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