Youth Boot Camp Registration Form

Name of Participant:*

First NameLast Name

Name of Parent*

First NameLast Name

E-mail*

How many children are you registering?*

Phone Number*

Area CodePhone Number

Are you a BCC Member?*

YesNo

Youth Boot Camp

For ELEMENTARY KIDS ONLY

12pm June 20th & 27th - Becker Community Center

Memebers: Free

Non-members $8

This course is designed to complement athletics BUT is more focused on fun movement to allow space for body awareness, control, and challenges. This is a gamified program; developing skills in communication, bravery, and resilience to create confidence. We will do that through active leadership activities, challenges, obstacle courses, and calisthenics. Students will be able to move in fun new ways that promote inclusiveness, accessibility, and participation.

Permission granted for participant to be included in pictures and publicity connected with the BCC with no compensation to me. All pictures and video remain the property of the BCC.

I agree to release the Becker Community Center, City of Becker, their employees and leaders, of all liability related to accidents or injuries which myself or member of my family might incur while participating in this activity. If necessary, I authorize the Becker Community Center to administer first aid and/or authorize medical treatment if this becomes necessary. Participants are not covered under the Becker Community Center's or the City of Becker's medical insurance policy.

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