Summer Camp Detailed Registration Form

Lions' Pride Summer Camp Registration
Summer Camp Registration
Athlete Information
Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
*Current Grade: 2019-2020 School Year
Current School
*2019-2020 School Year
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Shirt Size
Small/Medium/Large/XL
Parent/Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the athlete prescribed an inhaler? If yes, please explain any instructions.
Pick your Camp*

Girls' Basketball June 8-11 5pm-8pm *Evening campBoys' Soccer June 22-25 9am to 12pmBoys' Basketball June 22-26 9am to 3pm *All day campBaseball June 22-25 9am to 12pmGirls' Lacrosse July 6-9 9am-12pmBoys' Basketball July 6-9 8am-11am *Half day campBoys' Lacrosse July 13-16 9am-12pmField Hockey July 13-16 4pm-6pm *Evening campGirls Soccer July 20-23 9am-12pmTrack & Field July 27-30 8am-10amCross Country August 3-6 8am-10am
Signature and Date*

Clear
Insurance Company
Name
Policy Number
Group Number
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Camp Choice
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3 hour half day camp early bird plus $5 credit card fee$155.00
boys' soccer, baseball, football, girls' basketball, girls' lacrosse, boys' lacrosse, girls' soccer, boys' basketball half day camp

Quantity

all day camp registration early bird plus $9 credit card fee$289.00
boys' basketball

Quantity

2 hour camp early bird plus $4 credit card fee$125.00
cross country, track & field, field hockey

Quantity

Total $0.00
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Lions' Pride Summer Camp Registration

Summer Camp Registration