ASW 2023 Summer Junior Development Camp Registration

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Please fill out a separate form for each athlete and see the instructions at the bottom for payment details.

Email *

Athlete's Name (First & Last)
*

Date of Birth
*

YYYY

Grade (prior to summer)
*

T-shirt Size (Unisex)
*

Session(s) Attending
*

Session 1 (July 3rd to 7th)

Session 2 (July 10th to 14th)

Session 3 (July 17th to 21st)

Session 4 (July 24th to 28th)

Required

Street Address
*

City
*

Postal Code
*

Parent/Guardian 1

Name

Parent/Guardian 1

Phone Number

Parent/Guardian 1

Email Address

Parent/Guardian 2

Name (optional)

Parent/Guardian 2

Phone Number (optional)

Parent/Guardian 2

Email Address (optional)

Emergency Contact Name & Number

(if different from above)

Any specific health concerns?

(ie. allergies, Epipen, asthma with inhaler, etc.)

Waiver

I/we the parent(s) of the above named child/athlete hereby give my/our approval for their participation in the Sarnia Athletics Southwest Track and Field Club's Summer Junior Development Camp and all associated activities.

I/we assume all risks and hazards incidental to such participation, including transportation to and from

scheduled activities.

I/we waive, release, absolve, indemnify and agree to hold harmless the Sarnia Athletics Southwest Track and Field Club and its volunteer members, the associated instructors and all other parties associated with the conducting of activities for this track and field program from any claim arising out of any injury to my/our child/athlete.

I confirm that I have read and and understand the information above.

Required

Payment of Fees

The fee per child for each session is $90 CAD.

We ask that payment please be made in advance to your session starting or you will forfeit your child's spot in the camp.

The preferred method for payment is eTransfer to camp@sarniaasw.com (password: ASWCAMP).

However, we will also accept cash or cheque (made out to Sarnia ASW) to be submitted on the first day of your child's session.

I will be paying via:

Interac eTransfer

Cash

Cheque

Send me a copy of my responses.

Submit

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