Warrior Sports Camp Application

Student Name*

First Last

Grade Completed as of June 2012

Student is*

Male
Female

T-Shirt Size*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Warrior Sports Camps (Check all camps that you would like to register this student for)

June 4-8: Soccer
June 11-15: Basketball
June 18-22: Baseball
June 25-29: Volleyball
June 25-29: Tennis
June 25-29: Golf
July 9-13: Soccer
July 16-20: Basketball

Emergency Information

Mother's Name*

First Last

Mother's Cell Phone*

Father's Name*

First Last

Father's Phone*

Emergency Contact if parents can't be located*

First Last

Emergency Contact Phone Number*

I understand that neither the camp directors, Christian Academy staff and administration, nor anyone connected with the Camp will assume any responsibility for accidents/incident sustained during or as a result of, any course of instruction given the camper by the Camp staff. (By entering your first and last name, you are acknowledging your agreement with this statement)

Email Address*

(812) 944-6200

Warrior Sports Camp Registration

Emergency Information

Contact

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