LCHS Kids Winter Basketball Camp Registration
Event Timing: December 29-30, 2021,  1:00-3:00 p.m.
Event Address: Lake City High School
Contact James Anderson @  (208) 284-2918 or janderson@cdaschools.org
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Player Name *
Gender *
Required
School Currently Attending *
Grade for 2021-22 School Year *
Required
Parent Names: *
Parent Phone #'s *
Parent Email Address *
Additional Emergency Contact Person + Phone# *
Health Insurance Information - Include Company and Policy Number *
Medical Authorization - I hereby authorize my child’s participation in the Lake City Basketball Camp. I know of no physical or mental disorders which may affect my child’s ability to participate in this camp. I recognize the risks inherent in my child’s participation, and I assume full responsibility for all injuries that may arise. I waive and release the Coeur d’Alene School District and all instructors from any and all liability for any injuries incurred while participating in this camp.  Type Your Name Below to Agree with Medical Authorization *
Dietary restrictions, allergies, medical conditions we need to be aware of? *
I understand that I will have to pay $$ upon arrival - $60 or $40 for 2nd person from same family. *
Required
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