CAMPER INFORMATION NAME: ______________________________________ ADDRESS: ____________________________________ ___________________________________________ HOME #: _____________________________________ MALE: ______ FEMALE: ______ AGE: _______ Health Concerns: ______________________________ T-SHIRT SIZE: ADULT: S M L XL YOUTH: S M L XL PARENT/GUARDIAN: NAME:__________________________________________ WORK #: ________________________________________ ALTERNATE EMERGENCY CONTACT & # NAME: ________________________________________________ PHONE #: _____________________________________________ CONSENT FORM I wish my child to participate in the camp unless I advise you in writing. I agree that having taken such precautions as in your discretion are deemed advisable; you shall not be held responsible for any sickness or accident to my child. Parents are therefore reminded to see that their son/daughter is covered under one of their own Sickness & Accident Insurance Plans available at minimum cost throughout the year. If for any reason my child requires medical attention beyond that furnished by the camp I agree to be responsible for any expenses incurred. SIGNATURE: ________________________________________________ DATE: ____________________________________________________ FELLOWES SPORTS CAMP REGISTRATION OPTIONS: S 1. Mail orPDeliver form & payment to: O R School, 420 Bell Fellowes High Street, Pembroke, ONTARIO, S 5th Annual FELLOWES Sports Camp 2015 K8A 2K5. 2. e-mail: [email protected] Make cheques payable to: Fellowes High School COST: $145 REGISTRATION DEADLINE: ($130 for each additional family member) by mail or e-mail is Includes: T-shirt and Prizes FRIDAY, JUNE 5th FREE PIZZA Friday! LIMITED ENROLLMENT! BOYS & GIRLS AGES 7-14 (Entering Grades 3 -8) FELLOWES SPORTS CAMP OBJECTIVE: This sports camp will provide your child with a variety of opportunities to enhance their basic skills & fundamentals. Participants will develop sportsmanship, offensive and defensive skills as well as learning the rules of various sports. SPORTS INCLUDE: Basketball, Volleyball, Soccer, Floor Hockey, Beach Volleyball, Track & Field, Lacrosse, Gymnastics, Wrestling, Fun Games, Team Building Activities & more Instruction will be provided by quality coaching staff and qualified Phys-Ed teachers FELLOWES Sports Camp ONE WEEK ONLY! WHEN: ATTENTION PARENTS! Due to construction, we must use the first week of July. Next year, we plan to run two weeks so stay tuned! Monday – Friday, June 29th–July 3rd 9:00 am – 4:00 pm 5th Annual Fellowes Sports Camp WHERE: Cafeteria entrance@ Fellowes High School, 420 Bell St. Pembroke Children participating in the camp will require: Indoor shoes, outdoor shoes, lots of snacks, lunch, water bottle, hat & sunscreen 9:00am-4:00pm (8:30am drop off) 7 to 14 year olds! (Entering Grades 3 – 8 or Born 2007 or earlier) For more information call: Pat Childerhose at 613-401-9887 or 613-735-6858 ext: 350 [email protected] Fellowes Sports Camp Coordinators would like to thank all of our volunteers. We could not do this without you!
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