| Camper's Name (Girls): |
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State: |
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| Travel Team: |
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| Gender: |
Female
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| Classof: |
2012
2013
2014
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| Insurance Information: |
| Carrier: |
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| Policy#: |
Group#:
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I, the undersigned, submit that
my daughter is physically fit and able to participate in strenuous
activity and hereby waive adidas Jr Phenom Camp of all responsibility
for illness or injury sustained. I hereby authorize camp directors
to act on my behalf in their best judgment in any emergency medical
situation. I understand I am solely responsible for payment of
any such medical expenses and must provide adidas Jr Phenom Camp
with proof of medical and accident insurance. I understand that
my payment and deposit is non-refundable, non-transferable under
any circumstances, including injuries sustained, conflict of schedules,
or illness. I understand that Phenom products can not be given
in lieu of any refunds. I also understand that any camper who
does not abide by camp facility rules or regulations is subject
to dismissal without refund or recourse.
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Parent/Guardian Signature: Date: |
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| Are you staying in the Dormatory? (circle) |
YES......
NO
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| Camp Fees: |
-- $425 (You
take care of your own housing) |
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-- $495 (Housing
in the dormatory--2 night's stay; Fri/Sat night) |
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-- $150 non-refundable
deposit secures your spot |
| Items You Provide in the registration
packet: |
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º Proof of grade (report card, letter from school
or progress report) |
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º 3 x 5 photo (no computer printouts) |
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º Completed Biography |
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º Registration form |
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º Registration fees or deposit |
| Send Registration to: Adidas Jr Phenom
Camp, 26563 Rhone Ct., Moreno Valley, CA, 92555 |
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| Player's Name: |
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| Address: |
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| City, St, Zip: |
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| Contact Info: |
Phone:
email:
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| School: |
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| Travel Team: |
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| Position: |
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| Height: |
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| Weight: |
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| Class: |
2012
2013
2014
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| Uniform Size: |
adult size:
Uniform comes in a set
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| Hobbies: |
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| Fav Athelete: |
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| Nickname: |
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Registration Checklist: |
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Registration Form |
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Biography Form |
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Proof of Grade |
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Registration Deposit/Fees |
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Photo for Camp Program |
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* These items must be submitted
in full for registration to be accepted. Please check items before
submitting.* |
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