CMHS Softball Camp August 4-6, 2021
4:30-6:30 PM at the CMHS field
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Student Name (Last, First) *
Grade for 2021-22 School Year (Current) *
Parent Guardian Name (Last, First) *
Parent Guardian Mobile Number *
Parent Guardian Email *
Emergency Contact Name (Last, First) *
Emergency Contact Mobile Number *
Allergies/ Special needs *
Consent to participate/Medical release/Waiver:
In the event of illness or injury to my son/daughter/ward, I give permission to any licensed physician to give him/her such medical treatment as they may consider necessary for his/her health or safety. I authorize the camp director or her designee to seek such treatment on my behalf. I hereby further agree to defend, indemnify, save and hold harmless the Cheyenne Mountain School District, its employees, agents, and directors, as well as the staff of the Sports Camp, from and against any claim for any claims, damages, or injuries which may result from my child’s participation in the activity, and furthermore agree to waive any claims my child or my family may have against the School District for losses, damages, or injuries which may result from my child’s participation in the above activity.

Please type your name, serving as electronic signature for the waiver above *
Please bring payment of $50 to the first day of camp. Checks payable to CMHS Softball *
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