------------------------------------------------------------------------------------------Application Form (Please fill out and turn in) Camper Name: ________________________________________________________________ Age: _________________ Address: _____________________________________________________________________ ______________________________________________________________________ Emergency Contact Name & Phone #: _________________________________________ Grade Next Fall: ______________________________________________________________ *Attention Parents: I authorize the directors to secure any emergency treatment deemed necessary and understand that the basketball coaches, administration and RTHS will not be held responsible for injuries or loss of property while the above student is attending camp. Signature______________________________________________________________