2019 Volleyball Camp Form
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CAMPER'S NAME:________________________GRADE (2019 - 20):_______
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PHONE #:______________________________
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Lady Cat All-Skill Volleyball Camp
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WHEN:June 4th -6th (Tuesday-Thursday)
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TIME:3:00 P.M. - 6:00 P.M.
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AGES:Incoming 2nd - 8th Grade
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PLACE: Wink Gymnasium
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PRICE: $30
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T-Shirt Size: Youth Small _______ Medium _______ Large_______
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Adult Small _______ Medium _______ Large ______
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Registration form and money are due by May 20th. (late registration will be allowed, but t-shirt can not be guaranteed)
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Registration forms and money can be turned into your daughter's PE Teacher (Coach Archibald or Coach Ratliff).
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CONSENT FOR MEDICAL TREATMENT OF A MINOR AND RELEASE OF RESPONSIBILITY
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I, _______________________(full name of parent/guardian) declare that I am the _______________(Father, Mother,
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Guardian), of ____________________________ (full name of minor). I hereby authorize the staff of the Lady Cat
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Volleyball Camp, located in the City of Wink, County of Winkler, State of Texas to consent to any x-ray examination,
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anesthetic, medical or surgical diagnosis or treatment, and hospital care necessitated by injury or illness while the
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above named child is attending the Lady Cat Volleyball Camp. Such treatment is to be rendered to the minor
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under the general or special supervision and on the advice of a physician or surgeon licensed to the state of Texas.
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I hereby waive and release the camp from any and all liability for injuries or illness incurred while at camp, or while
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traveling to and from the camp.
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I hereby certify that I have read and fully understand this authorization.
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Date_____________ Signature_______________________________________________________________
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FOR MORE INFORMATION CONTACT:
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Heather Archibald @ (325) 374-4379
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or at harchibald@wlisd.net
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