Clinton High School 2017 High School Track Camp
Clinton High School 2017 High School Track Camp Registration Form Registration Due July 14, 2017
Date: July 24-26, 2017 Time: 5:00-6:30 Location: River King & Queen Athletic Complex Ages: Girls entering 9th-12th grade in the fall of 2017 or Cost: $15 with a t-shirt NON-REFUNDABLE $20 late registration fee Clinton High School Coan Field Please Make the Checks payable to Clinton Community School District Include this registration form Registration is $15 before June 30, 2017 Late Registration begins July 1st Late Registration is $20 by July 14, 2017 Athlete Name:____________________________ Age:_____________________ Grade Level, Fall 2017: _____________________ Home Address:____________________________________________________________________ Home Telephone:_____________________ Email: _______________________ Parent/Guardian Name:_____________________ Work/Cell:_____________________ Parent/Guardian Name: _____________________ Work/Cell:_____________________ If unable to reach parent/guardian, in case of an emergency contact: Name: Relationship:_____________________ Phone:_____________________ Please circle one T-shirt Size for Camp T-Shirt Youth: S M L Adult: S M L XL Medical Information/Release Does the athlete have any medical conditions we need to be aware of? If yes, please explain: I authorize the track coaches at Clinton High School track camp to act for me according to their best judgement in an emergency requiring medical attention, and I release Clinton Track coaches as well as Clinton High School from any and all liability for injuries, illnesses, or lost property incurred while the above named athlete is at camp. I have no knowledge of any physical condition that would be affected by the above named athlete’s participation in the camp Parent/Guardian Signature: _____________________ Date:_____________________ Please send your camp registration to: Coach Tony Steen-Attention Track Camp Clinton High School 817 8th Avenue South Clinton, IA 52732 For additional questions, please call Clinton High School, 563-243-7540
Date: July 24-26, 2017 Time: 5:00-6:30 Location: River King & Queen Athletic Complex Ages: Girls entering 9th-12th grade in the fall of 2017 or Cost: $15 with a t-shirt NON-REFUNDABLE $20 late registration fee Clinton High School Coan Field Please Make the Checks payable to Clinton Community School District Include this registration form Registration is $15 before June 30, 2017 Late Registration begins July 1st Late Registration is $20 by July 14, 2017 Athlete Name:____________________________ Age:_____________________ Grade Level, Fall 2017: _____________________ Home Address:____________________________________________________________________ Home Telephone:_____________________ Email: _______________________ Parent/Guardian Name:_____________________ Work/Cell:_____________________ Parent/Guardian Name: _____________________ Work/Cell:_____________________ If unable to reach parent/guardian, in case of an emergency contact: Name: Relationship:_____________________ Phone:_____________________ Please circle one T-shirt Size for Camp T-Shirt Youth: S M L Adult: S M L XL Medical Information/Release Does the athlete have any medical conditions we need to be aware of? If yes, please explain: I authorize the track coaches at Clinton High School track camp to act for me according to their best judgement in an emergency requiring medical attention, and I release Clinton Track coaches as well as Clinton High School from any and all liability for injuries, illnesses, or lost property incurred while the above named athlete is at camp. I have no knowledge of any physical condition that would be affected by the above named athlete’s participation in the camp Parent/Guardian Signature: _____________________ Date:_____________________ Please send your camp registration to: Coach Tony Steen-Attention Track Camp Clinton High School 817 8th Avenue South Clinton, IA 52732 For additional questions, please call Clinton High School, 563-243-7540
