Your Choice Basketball Shooting Camp
Please print this form and mail with payment to:
Your Choice
36 Park Drive
Albany, NY 12204
Make checks payable to: 'Your Choice'
| Camper's Name | ___________________________________________________ |
| Street | ___________________________________________________ |
| City | ___________________________________________________ |
| Zip | ___________________________________________________ |
| Home Phone | ___________________________________________________ |
| Cell Phone | ___________________________________________________ |
| ___________________________________________________ | |
| School | ___________________________________________________ |
| Grade (Fall) | _____________________ |
| Age | _____________________ |
| Emergency Contact | |
| Name | ___________________________________________________ |
| Phone | ___________________________________________________ |
| Training Cost: $120.00 | |
| Group Discount | $__________________ $10 off per person for groups of 3+ |
| Total Due | $__________________ |
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Liability Waiver I understand there is a possibility of accident and I assume the risk and responsibility while my child attends the Your Choice Shooting Camp at Our Savior's Lutheran School. I consent to emergency care as deemed necessary by Camp Management and/or a medical professional. Parent/Guardian (Please print name): ___________________________________________________ Signature: ___________________________________________________ Date: ______________________ |
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