HOLLIDAY HOOPS
CAMP
Name of participant
Full Address
Age of participant
Boy
Girl
Gender
Member of Carolina
Cougar's?
YES
NO
Contact Phone #
Contact Email Address
June 9-13
July 21-25
August 4-8
July 14-18 Elite Camp
Camp selection-
you may select more then one
Insurance Carrier
Policy Number
I, the undersigned, submit that my daughter/son is physically fit and able to participate in HollidayHoops basketball camp and hereby waive HollidayHoops, St.Mary's and Christ Church and staff of all responsibility for illness or injury sustained. I hereby authorize camp personnel and directors to act on my behalf in their best judgment in any medical situation. I understand I am solely responsible for payments of any such medical expenses and must provide Hollidayhoops basketball camp with proof of medical and accident insurance. I also understand that my payment is non-refundable and non-transferable under any circumstances.
Initial upon
agreement