Deer Lake Athletic Club 2019 Summer Camp Registration FormCamp Registration Agreement • April 25th, 2019
Contract Type FiledApril 25th, 2019Camper First Name: Last Name: Birth Date: Parent/Guardian 1 Name: Primary Contact #: Secondary Contact #: Parent/Guardian 2 Name: Primary Contact #: Secondary Contact #: Campers Address: Camper Age: Other Contact #: Parent Living Elsewhere Address (If applicable): Known Alergies/Medical Conditions: Emergency Contact/Authorized Person for Pick Up/Drop Off (Name & Number) 1: Emergency Contact/Authorized Person for Pick Up/Drop Off (Name & Number) 2: Camp Agreement:I warranty and represent that my child has no disbility, impairment or ailment that forever release and discharge the Club and its management from all such claims, prevents them from engaging in active or passive exercise. This represention is made demands injuires, action or cause of action. Consent: I consent to pictures being taken by me knowing the Deer Lake Athletic Club will rely upon it in allowing them to of my child by the Club and understand that such pictures will become the property of participate in club activite