RBSA ELITE CAMP FORM
Completion of
Email address *
Campers Name (put more than one for multiple children) *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Best Contact Number *
Your answer
Email Address *
Your answer
Multiple Children, List your ages.
Your answer
T Shirt Size *
If multiple t-shirts please list next sizes.
Your answer
Date of Birth *
MM
/
DD
/
YYYY
What is your primary position? *
Do you have a room mate preference *
Your answer
Father's Best Contact Number
Your answer
Are you coming with a team or as an individual *
Required
If you are coming with a team what team?
Your answer
Mother's Best Contact Number
Your answer
Best Emergency Contact Number *
Your answer
I give permission for my child to be treated by a doctor if necessary. They are physically fit according to our doctor. *
Required
Camper's Insurance company *
Your answer
Policy Number. *
Your answer
All Campers mush have their own medical coverage. The camp insurance is an excess coverage policy and is only filed after your insurance has been utilized. This does not include any deductibles. In signing this I agree to hold harmless from liability the RBSA, its employee's or facilities that are utilized *
Please type your full name
Your answer
A copy of your responses will be emailed to the address you provided.
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