Join the Lady Fisherman of Gloucester High School during a February Vacation mini camp! Who: 2-8 Grade Girls When: February 18, 19, & 20 from 9:00am-2:00pm Where: GHS Field House Cost: $80 per child for all 3 days, $30 to drop-in per day Please make checks out to Gloucester High Girls Basketball What to Bring: Sneakers, Water, Snacks & a Lunch * No Nuts Please! * No Jewelry Please! Contact: Coach Tara Driscoll Phone: (781) 820-0810 Email: tdriscoll20@yahoo - - - CUT HERE- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - CUT HERE - - - Girls Basketball Mini-Camp Registration Childs Name: _____________________________________________ Age: ______________ Parent/Guardian Name: _________________________________________________________ Address: _____________________________________________________________________ City: ______________________________ State: ____________ Zip Code: ________________ Telephone: _____________________________ Email: ________________________________ How did you hear about the camp? ________________________________________________ Medical Release Form In case of an emergency, if family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. First Response Team ER Physician). Family Physician: ____________________________ Telephone: ____________________ Address: _______________________________ City: _______________ Zip: __________ In case of an emergency, contact: Name: ________________________________________ Relationship to Child: ________________________ Telephone: ____________________ Please list any allergies/medical problems, including those requiring maintenance medication (i.e. Diabetes, Asthma, Seizure Disorder) _______________________________________________________________________
Posted on: Sat, 18 Jan 2014 19:12:31 +0000
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