2021 Lincoln HS Basketball Camp Registration Form
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Waiver and Release Agreement:
Upon acceptance of this agreement, I hereby waive and release all rights and claims for damages I may have against Lincoln High School, its employees, and it's guest staff members on account of any injuries or illnesses sustained by my child while attending camp. I authorize the director of the basketball camp or their designee to select hospital facilities and/or physicians of their choice if required. I authorize treatment on an emergency basis if such treatment is required as a result of my child participating in the Lincoln High School basketball camp.
Parent or Guardian Name(s) & relationship to camper: *
Parent/Guardian Email and Best Contact Number: *
Emergency Contact(s) [Name and Phone]: *
Student/Participant Name: *
Participant's Age and Date of Birth: *
Participant's Insurance Information (Please list the company, the policyholder, policy number): *
Please list all medical concerns/issues: *
Please specify which session the athlete is attending. Dates are listed below, and the times are 8:30am - 1pm. Drop off starts at 7:30am. *
Required
Current School Participant Attends: *
List any teams/programs participant currently plays with: *
Shirt Size (Be sure to note if it's a child or adult size): *
Please list any food allergies that the participant has: *
Additional Information:
-If paying by check or money order, please make it out to: Lincoln HS Basketball Camp
-Payments may be paid at the Lincoln HS Business Office or paid directly to Coach Daly
-Please contact Coach Ray Daly for any camp-specific questions at 850.487.2110 ext. 1305 or 850.459.6832; email: lincolnbballcamp@gmail.com
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