Summer Strength Camp

Summer Strength Camp

6th thru 8th grade, July 14th - 17th
Student's Name

First NameLast Name
Parent's Name

First NameLast Name
Parents E-mail*
example@example.com
Parents Phone Number*
Member*

YESNO
Grade*

6th7th8th
Emergency Contact *

First NameLast Name
Phone Number*
Please enter a valid phone number.
Payment must be made in order to reserve the spot for class.

Cost for the week $55

No refunds or partial payments.
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 members of my family might incur while participating in the above mentioned activity. If necessary, I authorize the Becker Community Center to administer first aid and/or authorize medical treatment if this becomes necessary. Participants in the above-mentioned activity are not covered under Becker Community Center's or the City of Becker's medical insurance policy. Photos and videos maybe taken for marketing purposes. By signing below, you agree to all the above and to be pictured and video recorded for the marketing use of program.
Signature*
Should be Empty: