Catholic Central Summer Camps

Athletic Camp Registration Form

Summer Camps 2023
Parent/Guardian *

First NameLast Name
Relationship to Student*
Parent, guardian, grandparent, etc.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Phone*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Emergency Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
How many children are you registering for?
Student Information

Fill out one section per student
Student Name #1

First NameLast Name
Grade School of Student #1
Grade Level
Student #1 Shirt Size
What camp(s) does this student want to attend?

Volleyball CampFootball CampGirls Basketball CampBoy Basketball CampDance CampSoccer Camp
Student Name #2

First NameLast Name
Grade School of Student #2
Grade Level 2022-2023
Student #2 Shirt Size
What camp(s) does this student want to attend?

Volleyball CampFootball CampGirls Basketball CampBoys Basketball CampDance CampSoccer Camp
Student Name #3

First NameLast Name
Grade School of Student #3
Grade Level 2022-2023
Student #3 Shirt Size
What camp(s) does this student want to attend?

Volleyball CampFootball CampGirls Basketball CampBoys Basketball CampDance CampSoccer Camp
Student Name #4

First NameLast Name
Grade School of Student #4
Grade Level 2022-2023
Student #4 Shirt Size
What camp(s) does this student want to attend?

Volleyball CampFootball CampGirls Basketball CampBoy Basketball CampDance CampSoccer Camp
Student Name #5

First NameLast Name
Grade School of Student #5
Grade Level 2022-2023
Student #5 Shirt Size
What camp(s) does this student want to attend?

Volleyball CampFootball CampGirls Basketball CampBoys Basketball CampDance CampSoccer Camp

My Products

Volleyball CampJuly 11 - 13, 8:00AM - 10:00AM, 5th - 6th grades, 10:15AM - 12:15PM 7th - 8th grades t-shirt included

$75.00 Quantity
Item subtotal:$0.00

Football CampJune 6 - 7, 9:00AM - 10:15AM, 5th - 8th grades, t-shirt included

$30.00 Quantity
Item subtotal:$0.00

Boys Basketball CampJune 19 - 23, 6th - 7th grades (8AM - 10AM), 8th - 9th grade (10AM - noon), t-shirt included

$50.00 Quantity
Item subtotal:$0.00

Dance CampJuly 10 -14, 9AM - 11AM, t-shirt included

$75.00 Quantity
Item subtotal:$0.00

Girls Basketball CampJune 26th-30th, 8AM - 9:30AM, 5th - 8th grades, t-shirt included

$90.00 Quantity
Item subtotal:$0.00

Soccer CampJune 12 -13, 9AM - 10:30AM, 2nd - 8th grades, t-shirt included

$30.00 Quantity
Item subtotal:$0.00

Enter coupon

Total

$0.00

Waiver of Liability: I assume all risk of peronal injury including death and damage to personal property that may be sustained by my child wh ile attending ond/or participating in this event I release CCI-IS and Immaculate Conception St. Mary Parish. including any unit or Division thereof. from any and all li abili ty for any injury, death, or damages that my child may suffer whether due to the negligence of the CCHS and Immaculate Conceptio n St. Mory Parish coaches and its directors, officers. employees. and volunteers from and against any and all actions, suits. claims, deman ds, causes of action. proceedings. losses. costs. and expenses including and without limita tion all attorney fees and disbursements. Damages. liability and fines or penalties in any way arising out of , or relating to. or connected with directly or indirectly, my child's participation in this event regardless of whether there is active or passive negligence or fault on the part of CCI-IS and Immaculate Conception St. Mary Parish or other related parties.
Signature*

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Athletic Camp Registration Form

Student Information