Form

Adv. Skills Girls Basketball 2017

For all girls in 7th-8th grades (as of Fall 2017)
June 7, 8 and 9, 2017; 10-11:30am
$40 per camper; $70 for 2 campers (siblings)
Camp is in the main gym at Bishop Chatard HS

Questions? Contact Head BCHS Girls Basketball Coach Katie Fisher at summercamp@bishopchatard.org

How many students are you registering? *

1 2

Player #1 *

First Name Last Name

Grade (Fall 2017) *

7 8

School Attending *

Player #2 *

First Name Last Name

Grade (Fall 2017) *

7 8

School Attending *

I would like to *

Pay Online Bring in my payment at the first session I attend

Choose the quantity below *

Girls Basketball Skills 2017 $ 40.00

Girls Basketball Skills 2017 - 2 Campers $ 70.00

Total $ 0.00

Credit Card
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Credit Card Number	Security Code
Expiration Month	Expiration Year

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Parent and Emergency Information

Parent/Guardian Contact *

First Name Last Name

Contact Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Primary Email *

We will send info about the clinic to this email

EMERGENCY Phone *

Where you can be contacted during the camp, in case of an emergency

Medical situations that we need to be aware of during the clinic.

I/We give permission for my child to participate in this activity sponsored by the Bishop Chatard High School Athletics Department. I/We hereby release Bishop Chatard High School and any of its designated helpers from any and all liability for any and all harm arising to my daughter as a result of this clinic. In the event of an emergency, I understand that school authorities will make every effort to contact me, but authorize those authorities to seek emergency medical treatment in a life-threatening or serious situation.

I give permission to BCHS to use photographs of my daughter taken during the camp activities, for BCHS marketing or other promotions.

Parents/Guardians: Type in the box below to indicate you have read the above and agree to these permissions.

Parent / Guardian Signature - Consent *

Date

- Month - Day Year

Adv. Skills Girls Basketball 2017

PAYMENT Details