2022 Lancer Power Camp (Speed, Strength & Conditioning)
Information for the Participants
1.) Fill out the form below
2.) Pay Online @ Parent Pay Online on the Lafayette Website
3.) Email Adam Hicks @ Hicksadam@rsdmo.org with any questions
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Email *
Athlete First Name *
Athlete Last Name *
Athlete E-mail Address *
Group Assignment
Clear selection
Grade (Entering in Fall of 2022)  *REGISTRATION FOR 6-8TH GRADE BOYS IS CLOSED -If you register and meet this criteria, it will not be accepted at this time due to the numbber of participants enrolled. We have reached our cap for this year. We hope to have them sign up for next summer* *
Session They will Attend 1 or 2- (Reference the sheet for further information) *10th-12th Grade Boys NOT playing Football have 2 options - MUST Select one session though for the summer) *
Weight Lifting Experience *
T-Shirt Size *
Legal Guardian E-mail Address *
Legal Guardian Phone Number *
Home Address (Street Address, City, Zip Code) *
Emergency Contact FIRST & LAST NAME (Someone other than the number you listed above) *
Emergency Contact PHONE NUMBER (Someone other than listed legal guardian) *
Rockwood Online Payment Portal Receipt Number *
DISCLAIMER AND WAIVER OF LIABILITY: I/WE BEING THE PARENTS AND / OR LEGAL GUARDIAN:  AUTHORIZE LAFAYETTE HIGH SCHOOL AND ITS EMPLOYEES AND AGENTS PERMISSION TO REQUEST EMERGENCY MEDICAL TREATMENT OR CARE AS NECESSARY TO INSURE THE WELL-BEING OF OUR/MY CHILD. FURTHER, I CLAIM THAT OUR/MY CHILD IS FOUND FIT FOR ALL PHYSICAL ENDEAVORS AS WELL AS BEING COVERED BY VALID MEDICAL INSURANCE. I HEREBY RELEASE LAFAYETTE HIGH SCHOOL AND ALL ITS EMPLOYEES AND AGENTS FROM ALL CLAIMS ON ACCOUNT OF ANY INJURIES WHICH MAY BE SUSTAINED BY OUR /MY CHILD WHILE PARTICIPATING IN THE CAMP AND ANY FUTURE CLAIMS HEREAFTER PRESENTED BY OUR/MY CHILD AS A RESULT OF ANY SUCH INJURIES.   *
Required
PRINT FULL NAME OF GUARDIAN for SIGNATURE for Acknowledgment of Disclaimer and waiver of Liability above. *
A copy of your responses will be emailed to the address you provided.
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