HCA Spring Break Basketball Camp 2019
Tuesday, April 16th & Wednesday, April 17th
9:00 a.m. - 12:00 p.m.
for current 6th - 10th graders
Camp will be run by HCA Coach Samuel Darche.
Camper First Name *
Your answer
Camper Last Name *
Your answer
Grade this School Year *
Parents' Names *
Your answer
Phone *
Your answer
Email *
Your answer
Parent Consent for Participation - Please sign below to acknowledge you have read this form and agree to the waiver below. *
I (We) herby give consent for our above mentioned child to participate in the HCA Spring Break Basketball Camp. WARNING: Participation in sports activities involves the potential for injury, which is inherent in all sports. By signing this permission form, you release Harvester Christian Academy, its employees, directors, staff, board, and any agent of the school of any liability for any injury incurred while participating in basketball camp. In the event of a medical emergency involving the above named athlete during my absence while participating in HCA Spring Break Basketball Camp, I hereby authorize the Harvester Christian Academy staff, school official, camp director or adult chaperone to arrange for and consent to any necessary medical services. This in no way obligates the director, coach, school official or chaperone for payment of services rendered if such occurs.
Your answer
Payment for Camp - Please type name below to acknowledge that you have read the following statement:
By typing my name below I authorize Harvester Christian Academy to bill by account in the amount of $50.00 for my child to attend the HCA Spring Break Basketball Camp on April 16th and April 17th of 2019.
Your answer
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