KHS Skills Training

Session Information

Location : Kearney High Main

Date : April 4th

Time:

2022-23 School Year Grades

7th-8th Grade - 8:00-9:00 PM

Cost : $10

Come in through the athletic entrance (west side). We will do small group instruction based on the availability of our coaches. The maximum players per session will be 16. This money will go to funding travel, entry fees and lodging for our High School teams this summer.

Athlete Information

Athlete's First Name *

Athlete's Last Name *

2022-23 Grade

7th8th

Parent/Guardian Information

Name*

First NameLast Name

Cell Number*

Area CodePhone Number

E-mail*

Emergency Information

Only fill out the emergency contact if different than the guardian contact information.

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Kearney High School during the selected camp. In exchange for the acceptance of said child’s candidacy by Kearney High School, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Kearney High School . and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Kearney High School including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

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.

SIGNATURE*

Check the box below and click submit. You will then go to PayPal where you can pay with an account or use a debit/credit card option as a guest. If you didn't receive a confirmation email - we did not get your submission. Please contact me with any questions - draberanek@kearneycats.com Thanks!

My Products

Camp Registration $10.00

Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Kearney Basketball Youth Skills Session

Payment Method