EWING TOWNSHIP RECREATION DEPARTMENT
2017 SUMMER BASKETBALL CAMP
BASKETBALL: Boys & Girls: Grades 4 – 8 Location: Ewing High School Gyms
CAMP Session: Monday, June – 26th – Friday, June 30th, 9am – 3pm,
Daily activities: 3 on 3, skills, speakers, prizes, awards & more
Cost: $75 per camper, T Shirt included
Registration Deadline: June 19th
Director: Shelly Dearden, EHS Boys’ Basketball Head Coach
FOR MORE INFO CONTACT THE EWING RECREATION DEPARTMENT AT 883-1776 X 2OR EMAIL Ted at .
CampRegistration Information
Name:______Date:______
Address:______
School:______PresentGrade:______Gender:______
Medical Conditions:______
Emergency Contact Info:______
Please list people dropping off and picking up camper. Staff may ask for ID.
1.______2.______
______Office Use Only______
Amount $______Cash______Check #______Credit Card______
Date:______Receipt#______Staff:______
ACKNOWLEDGMENTOFRISK - Program: Summer Camps
Iamawarethatparticipatinginthisactivitycanbedangerousandinvolvesriskofinjury.Irealizethatparticipationintheabove-mentionedactivitypresentsrisk,whichincludesminororseriousinjurytoanypartofthebody. Theseinjuriescouldleadtotemporaryorpermanentdisabilityorevendeath. Whilethepossibilityofseriousinjurytoparticipantsisunlikely,itisimportantthatallparticipantsandparentsrealizethattheserisksdoexist.
PARENT/GUARDIANAGREEMENT:
Inconsideration oftheEwingRecreation Department permitting thenameminortoparticipate intheRecreation Department previously mentioned, the undersigned, being the parent(s) or legal guardian of
______herebywaiveand relinquish all claims I(we)mayhaveasaresultofsaidminorparticipatingintheprogramagainsttheEwingTownshipRecreationCommission,EwingTownshipRecreationDepartmentandEwingTownshipMayorandCouncil,itsoffices,agents,servantsandemployeesfromanyandallclaimsforinjuriesincludingdeath,damageorlossofpropertywhichmayaccruetousonaccountoftheminor'sparticipationinsaidprogramandwefurtheragreetohold harmlesstheEwingTownshipRecreationCommission,Ewing RecreationDepartmentandEwing TownshipMayorandCouncil,itsofficers,agents,servants,andemployeesfromanyandallsuchclaims.
Parent/Guardian______Date:______
Signature
Print Name______