2023 Malcolm Youth Football/Basketball Camp Registration Form(June 12th to June 14th)

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Please complete this form and please send your payment to Scott Amen 6 Beckman Circle Malcolm, NE 68402
Venmo Payments to @Scott-Amen

You can also turn in your payment to Coach Amen or Coach Lewandowski at school. T-Shirt/Short Deadline is May 17 in order for delivery purposes. THE DEADLINE HAS PASSED FOR A GUARANTEED T-SHIRT/SHORT

Email *

Student's Full Name *

What camp would you like to attend? *

Both Basketball and Football $65

Basketball only $35

Football only $35

Participants will receive EITHER a Camp Shirt or Camp Shorts. Please select the size for a SHIRT.(Deadline May 17, 2023) *

Participants will receive EITHER a Camp Shirt or Camp Shorts. Please select the size for SHORTS.(Deadline May 17, 2023) *

Grade that they will be entering: *

Student's Age *

Parent's Name *

Address *

Phone Number *

Parent Email *

In consideration of your accepting this entry I hereby for myself, my heirs, my executors, and administrators waive and release Malcolm High School and/or all of their agents, officers, coaches, and/or team members from any and all claims or rights for damage, injury or losses directly or indirectly in attendance or participation in the 2023 Malcolm Basketball and Football Camps. By checking Yes, your son will be allowed to participate in the Youth Camp. *

Yes

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