2015 Kearney High Volleyball Camps Camp Opportunities: th th June 810 , 2015 35 Graders 810 AM Cost: $40 includes TShirt th th June 810 , 2015 68 Graders 10AM12PM Cost: $40 includes TShirt th th July 1315 , 2015 912 Graders 911:30AM & 13:30 Cost: $55 includes TShirt Camps are at Kearney High School North and South Gyms CheckIn on Day 1 is in the South Gym th Please fill out the bottom portion and return to: Jessica Day at 1720 E. 45 St. Kearney, NE 68847 th th Registration Deadline for 3-5and 6-8Grade Camps is on June 2, 2015 th th Registration Deadline for 9-12 grade camp is July 7 , 2015 Checks made out to: Jessica Day Questions: Please contact Coach Day at 402-212-0642 or [email protected] Confirmation will be emailed. ------------------------------------------------------------------------------------------------------------------------------------Player(s) Name ______________________________________________________________________________________________________ Parent(s) Name ______________________________________________________________________________________________________ Address _______________________________________________________________________________________________________________ Email ________________________________________________________ Phone _________________________________________________ Grade Fall of 2015 ______________School_______________________________ Emer. Phone _______________________________ th Camp Attending: (Grade going into fall of 2015) 3-5Grade __________ th 6-8 Grade __________ th 9-12 __________ T-Shirt Size: Youth S _____ Youth M _____ Youth L _____ Small _____ Medium _____ Large _____ X-Large _____ Total Included with check made out to Jessica Day $ __________________ (No refunds after June 2nd- unless with Doctor note) PARENT’S RELEASE AND INDEMNITY AGREEMENT: I certify that the participant is covered by medical insurance and accept responsibility for payment of all medical and related services arising from participation in the 2015 Bearcat Volleyball Camp. I hereby release Kearney Public Schools, Jessica Day, and all other camp employees from all claims on account of any injury, which may be sustained by our (or my) child while attending the 2015 Bearcat Volleyball Camp. Signature__________________________________________________ Date ____________________________________
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