Mega Sports Camp Registration  June 5-9, 2017   9am-12noon
 
Mega Sports Camp Registration June 5-9, 2017 9am-12noon
How many children are you registering today?  * 
Each child registered on this form must belong to the same household with same address and parent or guardian. If not, please register each child separately.
Mega Sports Camp offers soccer, cheerleading and basketball for kids Grades 1-6. Baseball is offered for kids Grades 3-6.
Child #1
Child #1 Last Name  * 
Child #1 First Name  * 
Child’s Address, City Zip Code  * 
School Grade Completed as of June 1, 2017?  * 
Sports Choice  * 
Baseball players: Please bring a glove and hat with your name written on them.
T-Shirt Size  * 
Child #2
Child #2 Last Name
Child #2 First Name
Last School Grade Completed
Sports Choice  * 
T-Shirt Size
Child #3
Child #3 Last Name
Child #3 First Name
Last School Grade Completed
Sports Choice  * 
T-Shirt Size
Parent or Guardian Information
Guardian(s) Name  * 
Guardian(s) Home Phone  * 
Guardian(s) Cell Phone  * 
Guardian(s) Work phone  * 
In case of emergency, list contact name.  * 
Emergency Phone number  * 
Emergency Phone Number
List Your Church Affiliation. If none, write none.  * 
Cost per registered child is $25.00. Please select the number of children you are registering on this form. If paying at the church office, bring the email registration receipt.  * 
Child #1 Health Information
Special Concerns (allergies, medications, medical conditions, etc.) If none, write none.  * 
Child #2 Health Information
Special Concerns (allergies, medications, medical conditions, etc.) If none, write none.
Child #3 Health Information
Special Concerns (allergies, medications, medical conditions, etc.) If none, write none
Do you fully release & hold harmless TEMPLE BAPTIST CHURCH, its volunteers & staff from all liability for any accident, injury or death while attending Mega Sports Camp?  * 
If you are unavailable in the event of an accident or emergency, do you authorize a church representative to make arrangements for your child to receive medical care?  * 
Do you authorize the physician named below to provide care and treatment for your child as deemed necessary in the event of an accident or medical emergency?  * 
Physician’s Name & Phone Number
Do you attest that adequate insurance is in effect to cover your son or daughter while attending Mega Sports Camp?  * 
List Insurance Provider, Policy # or Policy ID Information
Your Email Address  * 
Total $
 
 
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