Mega Sports/Art Camp Registration Form 2012
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Transcript of Mega Sports/Art Camp Registration Form 2012
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7/31/2019 Mega Sports/Art Camp Registration Form 2012
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Name________________________________ Grade Last Completed____________Address ____________________________________________________________City_______________________________________ State_______ Zip __________Guardian(s) name_____________________________________________________Home phone (____)______________Cell phone (_____)______________________
E-mail Address_______________________________________________________Age ______ Male____Female_____In Case of Emergency Contact:Name:_______________________________ Phone:________________________Person Authorized to Pick Up Child:______________________________________Special Concerns (Allergies, Medications, Conditions):
___________________________________________________________________
T-shirt size: [ ] -Y S [ ] -Y M [ ] -Y L [ ] -A S [ ] -A M [ ] - A L
ACTIVITY CHOICE (1 for first choice 2 for second if first is not available)[ ] Soccer (bring a soccer ball and shin guards labeled with your name)[ ] Basketball (bring a basketball labeled with your name)[ ] Cheerleading (wear comfortable shoes)[ ] Baseball / Softball (bring ball and glove labeled with your name)[ ] Art (wear appropriate clothing)
Every sport camper needs to carry in a pair of non-marking tennis shoes foruse on the gym floor.
I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, named above, tattend the camp/clinic. In order that my child may receive the proper medical treatment in the eventthat he/she may sustain injury or illness during MEGA Sports Camp, I hereby authorize the camp sta
to obtain or provide medical treatment for my child for such injury or illness during the camp, and Ihereby hold the camp staff and sponsoring organization (s), as well as its representatives, harmless ithe exercise of this authority. I further understand that there is always a possibility that my child maysustain physical illness or injury while at the camp. If this occurs, I hereby authorize the camp staff
and representatives to refer my child to a medical treatment center (hospital, etc.). I furtheracknowledge and understand that I will be responsible for any medical bills that may be incurred on
behalf of my son/daughter for physical illness or injury that he/she may sustain during the camp.Understanding that there is always a possibility that my child may sustain physical illness or injury, Iacknowledge and understand that my child is assuming the risk of such physical illness or injury by
his/her participation, and I further release the sponsoring organization and its representatives fromany claims for personal illness or injury that my child may sustain during the camp. I further
acknowledge and understand that my child will be responsible for his/her failure to abide by the rulesand regulations of the camp. Finally, in signing this document I give permission for the use of
photographs and videos including my child to be used in camp publicity.Todays Date___________Signature of Parent or Guardian:______________________________
Please Make Checks Payable To Valley Harvest Church (Sorry No Refunds)Valley Harvest Church 104 Tennis Center Dr. Marietta. OH 45750
For More Info: [email protected] (740)373-0867www.vbssportscamp.com
mailto:[email protected]:[email protected]
