Boys Basketball Camp Registration
July 12, 2021 (9am-1pm)
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Athlete’s Name *
Grade for 2021-2022 School Year *
Date of Last Physical *
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Parent/Guardian Name *
Parent/Guardian Contact Number *
Parent/Guardian Email *
Emergency Contact Name *
Emergency Contact Phone Number *
I grant permission for my child to be photographed, videotaped, and/or interviewed for the use in district-provided, school and teacher websites, social media pages, publications, displays, newspapers or television broadcasts. *
I hereby give my consent for the above-named student to participate in school athletics including various athletic practices, competitions and camps. I understand it is my responsibility to provide health insurance coverage for this student. I further understand WALTRIP HS/Houston ISD  is not liable for any injuries resulting from participation in school athletics. If in the judgment of any representative of the school, this student needs immediate care and treatment as a result of any injury or sickness, I do hereby request, authorize and consent to such care and treatment as may be given to said student by any physician, trainer, nurse, hospital or school representative. TYPE NAME BELOW AS SIGNATURE. *
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