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ADVANCED CAMP
or
DEVELOPMENT CAMP
phone
(540) 422-7330
MEDICAL RELEASE
KRHS DEVELOPMENT CAMP
$75
GRADES 6 - 10 (9AM - 2PM) p rat h t c s a n e o fe o ts o d dem er. Thes EARLY REGISTRATION: $100 sist c n e o th an ay asp ill c pw am ectures tball pl n by bo e m t a l c d l aske e give k e t b a l l an clude bring a bagged lunch This a b u r e b d n i i s t l l t v l a l i i o e a s b d l b w b a in a s rsit y basket lp will ecome tration a p v t s Cam s to b mons boy presen p to he y d e a n / d m t a on w es and ir ls ral pas ging ca m e ! g r n e u n ga lect ttle Ru ith sev challe heir
lls f dri di
g ovin r p im .
AN V D A
M A C CE
My daughter/son is physically capable of participating in the camp. I hereby give my permission for a qualified physician, certified athletic trainer and/or hospital emergency personnel to administer necessary medical attention, or camp staff to administer necessary first aid in case of injury. I also understand that Kettle Run High School, nor anyone connected with the camp, will assume responsbility for accidents, or other expenses incurred as a result of accidents during the camp.
________________________________
Parent Signature:
Emergency Contact:
_______________________
Relation:
basketball shoes
( _______ )________-________
Phone: