TIM
HORTONS VOLLEYBALL KENT CAMP
REGISTRATION
FORM – 2009
(PLEASE
PRINT)
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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:
__________________________