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2022 GLACIER BBB ELEMENTARY SCHOOL CAMP
Who: Grades 2nd-5th in Fall 2022
When: June 20, 2022 to June 22, 2022
Times: 12:00 PM to 2:00 PM
Location: Glacier High Gym
Camp Director: Mark Harkins
Contact Info:
harkinsm@sd5.k12.mt.us
Complete this form & make payment to register for this camp.
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Email
*
Your email
FIRST NAME (CAMP ATTENDEE)
*
Your answer
LAST NAME (CAMP ATTENDEE)
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Your answer
CAMPER'S GRADE IN FALL OF 2022
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2
3
4
5
CAMPER'S TSHIRT SIZE
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S
M
L
XL
Youth S
Youth M
Youth L
PARENT/GUARDIAN NAME
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Your answer
PARENT/GUARDIAN CONTACT NUMBER
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Your answer
PARENT/GUARDIAN CONTACT EMAIL
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Your answer
EMERGENCY CONTACT
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Your answer
EMERGENCY CONTACT NUMBER
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Your answer
My child has the following known medical conditions (enter N/A if none apply):
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Your answer
My child has the following allergies (enter N/A if none apply):
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Your answer
BY INITIALING THE LINE BELOW, I AM RELEASING ALL EMPLOYEES OF GLACIER CAMPS FROM ALL CLAIMS OF LIABILITY ON THE ACCOUNT OF INJURY SUSTAINED BY MY CHILD (NAMED ABOVE) WHILE ATTENDING GLACIER CAMPS. I FURTHER RECOGNIZE THE CAMP DIRECTOR TO ACT FOR ME IN HIS/HER BEST JUDGMENT IN THE CASE OF EMERGENCY REQUIRING MEDICAL ATTENTION.
*
YES
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PAYMENT
*
Boys Elementary School Basketball Camp - $50
Required
A copy of your responses will be emailed to the address you provided.
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