Rudder Ranger Summer Skills Camp:                       June 17th & 18th  
Please fill out this form completely AFTER paying your fee online.  
Sign in to Google to save your progress. Learn more
Email *
Participant Name *
What is your registration ticket number (check your ticket confirmation email)
Grade Entering Fall 2024
Clear selection
T-Shirt Size
Clear selection
Parent Contact Name *
Address *
Parent Email *
Parent Phone Number *
Consent for Medical Treatment: As the parent/guardian of student being registered for Summer Skills Camp, I hereby authorize the staff of the Rudder Girls Basketball Camp, located in the city of Bryan, County of Brazos, and State of Texas, to consent to any examination or care necessitated by injury or illness while the above named child is attending any of the Rudder Basketball Camps.  Such treatment is to be rendered to the minor under special supervision and on the advice of a physician licensed to practice in the state of Texas.  I hereby waive and release the camp from any and all liability for injuries or illness incurred while at camp, or while traveling to and from the camp.  I agree that I will pay any hospital expenses, doctor bills, and any other expenses that may be incurred as a result of treatment given to my son for the camp related injuries in excess of that provided by the campers’ insurance.  I understand that “camper’s insurance” does not cover any expenses incurred as a result of illness.  I make these statements and commitments as consideration of your allowing my son/ daughter to be enrolled in your camp and to take part in all of its activities.  I hereby certify that I have read and fully understand this authorization. *
Required
Does your child have any allergies? Please say none or list allergies below. *
Does your child have any medical conditions we should be aware of? Please say none or list below. *
Does your child take any medications? Please say none or list below. *
Who should we contact in case of Emergency? *
Phone Number of Emergency Contact *
Medical Insurance Company Name: *
Medical Insurance Policy Number *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Bryan ISD. Report Abuse