Meigs High Skills & Drills Camp
Multiple Sibling Discount -  (Must be immediate family member) (Please submit one form per child)
1st Child $40 each additional child $30. 

Pre-Register - $40
At the Door - $50

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Student First Name
Student Last Name
Grade Fall of 2023
Parent Cell Number
Allergies/Medical History to be aware of
Medication
Date of Birth
MM
/
DD
/
YYYY
Age
Address, (Street & City)
EMERGENCY CONTACT 1 (Name & Phone Number)
EMERGENCY CONTACT 2 (Name & Phone Number)
Family Physician  
Family Physician Phone Number
 Insurance Provider
Insurance Subscriber ID #
By my signature(s), I (we) give approval for the above child to participate in any and all activities of the Basketball Camp. I (we) assume all risks and hazards incidental to the conduct of the activities. I (we) agree to release, absolve, indemnify, and hold harmless the Meigs High Basketball Players, coaches and supervisors in the case of injury to our child during these activities. I (We) also agree that the MHS Bball players & coaches may photograph this event and those photos may be used on our website or other media for future advertising. ****TYPE NAME & DATE FOR SIGNATURE***
Medical Authorization To whom it may concern: If neither parent can be contacted in the case of injury or illness, I hereby authorize representatives of the MHS Basketball Coaching Staff to act as my agent to secure emergency medical treatment for ______________ , a minor child for whom I am responsible, at the nearest hospital, when in the opinion of the representatives, such emergency medical treatment is deemed appropriate during the time when my child is engaged in the camp activity. I hereby agree to hold the MHS Basketball Camp and its representative harmless for exercising its judgment in authorizing such emergency treatment and said representatives are specifically authorized to sign any required medical emergency hospital treatment form on my behalf.  ****TYPE CHILD'S NAME & DATE BELOW***
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