Trèchul, LLC
Trèchul, LLC
Efficiency, Productivity, Time
CC BASKETBALL SKILLS CAMP
CANGREJERAS VOLLEYBALL
Camper's Name
*
First Name
Last Name
Select Sport Activity to Participate
*
Basketball or Volleyball
Basketball
Volleyball
Age
*
Date of Birth
MM
DD
YYYY
Sex
*
Male
Female
Non-Binary - Other
Phone
*
Home or Mobile phone number
(###)
###
####
Email
*
T-Shirt Size
*
Small
Medium
Large
X-Large
XX-Large
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Parent or Guardian Information
Parent or Guardian #1 Name
*
First Name
Last Name
Parent or Guardian #1 Phone Number
*
(###)
###
####
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Parent or Guardian #2 Information
If applicable
Parent or Guardian #2 Name
First Name
Last Name
Parent or Guardian #2 Phone Number
(###)
###
####
Email
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Authorized Pick Up and Emergency Contact Information
At dismissal and/or in case of emergency the following people are authorized to pick up my child
Parent or Guardian #1
Yes
No
Parent or Guardian #2
Yes
No
Other People
18 years old or older are required
First Name
Last Name
Relationship
Relative
Friend
Other
Other People
18 years old or older are required
First Name
Last Name
Relationship
Relative
Friend
Other
Allergies and Medical Information
MEDICATIONS CANNOT BE GIVEN TO ANY CHILD BY ANYONE EMPLOYED BY THE STAFF OF THE CC BASKETBALL CAMP
Participant's Allergies
Participant's Medical Conditions
Responsibility Waiver
I, in charge of the athlete, certify that he or she is completely fit to participate in all the activities of the program. I also authorize your transfer to the nearest health center and to receive treatment in case of an emergency. I release the Carla Cortijo Basketball Skills Camp, any of their representatives, and the Municipality of San Juan, its employees, coaches and agents from all responsibility for any claim, suit or demand that may be presented. I certify that the athlete is in good health and is fit to perform rigorous physical activities.
*
Accept
Name
*
First Name
Last Name
Thank you!
Polideportivo rebekah colberg
(Escuela del deporte de San juan)
