TIM HORTONS VOLLEYBALL KENT CAMP

REGISTRATION FORM – 2009

HIGH POTENTIAL POSITIONAL CAMPS

(PLEASE PRINT)

Mail Registration Form to:

 

Randy Bartlett

440 Gregory Line East

Chatham, ON

N7M 5J7

 

Visit our website at:

www.volleyballkent.org

 
 


Camp Attending (Please check next to your selection)

q       Setters Camp: June 27 – June 28 ŕ $130.00

Athletes born in 1992, 1993, 1994

 

q       Hitters Camp: June 27 – June 28 ŕ $130.00

Athletes born in 1992, 1993, 1994

 

q       Defensive Specialist Camp: June 27 – June 28 ŕ $130.00

Athletes born in 1992, 1993, 1994

 

Cheque payable to: Volleyball Kent Camp

Name: _______________________________________________________________

˙Female    ˙Male

Birthdate: __________________________ Age at Camp: ______________________

Grade (Sept ‘09): ______ School attending (Sept ‘09): ________________________

Address: _____________________________________________________________

City: ______________________________ Postal Code: _______________________

Phone: ______________________

E-mail: _______________________________________________________________

Health Card #: ____________________________________

Playing Experience: _____________________________________________________

______________________________________________________________________

T-Shirt Size: Adult: ˙S    ˙M     ˙L     ˙X L      ˙Youth: L

 

Consent: We reserve the right to refuse enrolment or dismiss a camper if it is in the best interest

of the camp and/or camper. There will be no refund of any or part of the camp fee

if a camper is dismissed for inappropriate behaviour. We cannot be held responsible for

any loss or damage to Camper’s belongings. Permission is given to photos or video

excerpts of campers which may appear in the camp brochure or other advertising. The

Lambton-Kent District School Board, the St. Clair Catholic District School Board, the Municipality

of Chatham Kent and the Tim Hortons Volleyball Kent Staff shall not be held liable for any loss or injury.

Cancellation Policy: You will be assessed a $25 Administration Fee for any cancellation

from the Volleyball Kent Camp.

NSF Cheques: You will be assessed an Administrative Fee of $25 fee for submitting an

NSF cheque.

 

Date: _________________ Parent’s Signature: __________________________