2022 Lady Comets Basketball Camp

CHS LADY COMETS BASKETBALL CAMP
JUNE 13 - 16, 2022

9:00 am -12:00 pm

OPEN TO GIRLS AGES 7 - 15

CLAYTON HIGH SCHOOL GYM

COST: $75.00 (Early Bird price of $60 if registered before 5/13!)

MAKE CHECKS PAYABLE TO COMET ATHLETIC BOOSTER CLUB
Click HERE for more information on:
- What to Bring
- Schedule
- What to Expect
- Camp Staff
Name
Age
Parent/Guardian
Address

Address

Street Address Line 2

City State

Zip
Home Phone
Work Phone
Email
T-Shirt Size
Position
School Attended
Upcoming Grade in School
Basketball Coach
Insurance Company
Policy Holder
Primary Physician
PARENT AND MEDICAL CONSENT / RELEASE
My child has my permission to attend the 2022 Lady Comets Basketball Camp. In the event of illness or injury, I hereby grant permission for the attending physician or appropriate medical personnel to secure proper treatment. I will be responsible for any medical or other charges connected with my child’s attendance at camp. In acceptance of this applicant for camp, I hereby release Clayton High School and all its employees from all claims or damages that may be sustained by my child in association with this camp.
Is there a history of:
Medical conditions currently under treatment

Yes No
Pre-existing injury currently under treatment

Yes No
Fractures or other disability type injuries

Yes No
Any medications presently being taken

Yes No
Allergies (drugs, bee stings, food, asthma)

Yes No
Mental disorder or physical handicaps

Yes No
Known past illness of more than one week

Yes No
Contact lens or glasses

Yes No
Explain above questions answered "yes".
I hereby state that the CHS Basketball Camp and its employees are not responsible for any pre-existing injury or recurrence of any undisclosed pre-existing injury or illness of the above camper prior to the first day the camper registers.
Parent/Guardian Signature

Sign with mouse/cursor Clear
Date

Month Day Year
Date
Emergency Phone Number
Select Payment Method

Credit Card Mail Check/Cash Bring Payment First Day of Camp

Checks should be made payable and mailed to:

Comets Athletic Booster Club

600 S. Fayetteville St.

Clayton, NC 27520
Any questions, please contact Coach Marlon Lee:

marlonlee@johnston.k12.nc.us
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CHS LADY COMETS BASKETBALL CAMP

PARENT AND MEDICAL CONSENT / RELEASE

Credit Card