Rome High Youth Basketball Camp 2021

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Email *

CAMP DATES: June 14-17

COST: Before May 28th - $50 /After May 28th or day of Camp Day - $60

LOCATION: Rome High School Gym 9:00 am - 2:00 pm

Athlete's First Name *

Athlete's Last Name *

Date of Birth *

YYYY

Age *

Grade Entering 2021 *

What school do you attend? *

Parent / Guardian Name *

Parent / Guardian Phone Number *

Parent email *

Shirt Size *

Emergency Contact Name *

Emergency Contact Relationship to Athlete *

Emergency Contact Phone *

Release of Liability / Parental Consent:

I give consent for my child to attend the RHS Basketball Camp. I hereby release and hold harmless this Rome Athletics Program/Rome City Schools for injuries including those resulting in death and illness occurred while attending camp or as a result of attending camp.. I certify that my daughter is physically fit to participate in basketball camp. The coaches and staff will not be held liable for any accident, injury, or any illness that may occur while participating in camp activity.

Parent Name: *

YOU MUST SIGN BEFORE YOUR CHILD CAN PARTICIPATE IN THE CAMP.

Date Release of Liability was singed. *

YYYY

Click Below for Payment Options

Method of Payment *

Cash / Credit / Debit - Due at Rome High Front Office no later than May 28, 2021

Check - Made to Rome Lady Wolves Basketball- Due at Rome High Front Office no later than May 28, 2021

Pay $60 on June 14th at Rome High School.

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