Volley Ball - Camp Form-2015 - Flint Hills Christian School
FHCS Warrior Volleyball Camp JULY 20-24 Junior High (grades 6-8): 9:00 – 11:30PM Flint Hills Christian school 3905 green valley rd. Manhattan, KS 66502 Cost: $40 (Junior High) (make checks payable to fhcs) Send attention to: Tim McDonald * There will be a cap of 30 campers for each session Boys and girls will participate in the same activities Insurance All campers must be covered by their own insurance while attending the camp. Please provide your information below in the event of an emergency. Health Insurance Company _________________________________________________________ Policy number ____________________________________________ Physician’s Name __________________________________ Phone _________________________ Parent Name ______________________________________ Day Phone _____________________ Registration and Parent Release Waiver – Please return with payment We/I give permission for ___________________________ to participate in the Flint Hills Volley Ball Camp and verify that she is physically able to participate in all camp activities. We/I authorize staff members of the FHCS volley ball camp to act in the best interest of my son in case of emergency. We/I hereby assume all risks of injury & release Flint Hills Christian School, Tim McDonald and all staff members from claims on account of any injuries or damages that might occur while participating in the camp. We/I authorize and provide consent for licensed medical providers to administer any medical treatment or procedure advisable by the attending physician. I have read this agreement and understand it. Camper name: ________________________________ Camper grade (going into): ______________ Address: _______________________________________________________________________________ Email: ____________________________________________ Home Phone: ________________________ Camp registering for: ____ Junior High Phone in case of emergency: _______________ Date: _________________ Parent signature: _________________________________ Please send registration along with payment to: Tim McDonald FHCS 3905 Green Valley Road Manhattan, KS 66502 You may contact Tim McDonald for questions or more information at [email protected]
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