ILC Basketball Camp Registration
Running Sunday October 16th- November 13th

Sign in to Google to save your progress. Learn more
Name (First & Last)
Age Category
Home Address
Parent/Guardian Name
Phone Number
Email Address
Emergency Contact Phone Number
Medical Information (i.e. medical conditions, allergies, etc)

Liability Waiver (signed by the parent if the participant is under the age of 18)

Physical activity and sport is fun and healthy.  Being physically active is very safe for most people (both adults and children) however, even though all safety factors are in place, there is a risk of personal injury by participating in this program.

Therefore, please check below that you have read and understand the above statement.

As parent/guardian of the child identified above, I agree and understand that I will not hold Immanuel Lutheran Church liable for any consequences that may result from my child’s participation. I, being parent or guardian of the child named above, do hereby consent to the said child participating in all of the activities of the Immanuel Lutheran Church basketball program, and do hereby release, indemnify and save harmless Immanuel Lutheran Church, their employees, and volunteers from any claim which I or the said child may have as a result of their participation. I assume all risks and hazards and hereby waive all claims whatsoever the said child or I may have against the above named company or individuals.

*
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy