Volley Ball - Camp Form-2015 - Flint Hills Christian School

FHCS Warrior Volleyball Camp
JULY 20-24
Junior High (grades 6-8):
9:00 – 11:30PM
Flint Hills Christian school
3905 green valley rd.
Manhattan, KS 66502
Cost: $40 (Junior High)
(make checks payable to fhcs)
Send attention to: Tim McDonald
* There will be a cap of 30 campers for each session
Boys and girls will participate in the same activities
Insurance
All campers must be covered by their own insurance while attending the camp.
Please provide your information below in the event of an emergency.
Health Insurance Company _________________________________________________________
Policy number ____________________________________________
Physician’s Name __________________________________ Phone _________________________
Parent Name ______________________________________ Day Phone _____________________
Registration and Parent Release Waiver – Please return with payment
We/I give permission for ___________________________ to participate in the Flint Hills
Volley Ball Camp and verify that she is physically able to participate in all camp activities.
We/I authorize staff members of the FHCS volley ball camp to act in the best interest of my
son in case of emergency. We/I hereby assume all risks of injury & release Flint Hills
Christian School, Tim McDonald and all staff members from claims on account of any
injuries or damages that might occur while participating in the camp. We/I authorize and
provide consent for licensed medical providers to administer any medical treatment or
procedure advisable by the attending physician. I have read this agreement and understand
it.
Camper name: ________________________________
Camper grade (going into): ______________
Address: _______________________________________________________________________________
Email: ____________________________________________ Home Phone: ________________________
Camp registering for:
____ Junior High
Phone in case of emergency: _______________
Date: _________________
Parent signature: _________________________________
Please send registration along with payment to:
Tim McDonald
FHCS
3905 Green Valley Road
Manhattan, KS 66502
You may contact Tim McDonald for questions or more information at [email protected]