2012 Walton Boys Summer Basketball Camp Registration

2012 Walton Boys Summer Basketball Camp

Registration Form
Player Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
E-mail Address
Session
Grade (Rising)
Parents(s) or Guardian(s)
First Emergency Contact
Cell Phone

Area CodePhone Number
Relationship to Participant
Date

MonthDayYear
Second Emergency Contact
Cell Phone
T-Shirt Size
Liability Release

I, the undersigned, realized that participation in this camp contains inherent risks and dangers that may result in injury to participants. I will not hold liable Walton High School, this camp, or any of its agents for accidents or injury that may may occur during participation in this Camp.
Parent or Guardian
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